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12455 Broadwell Rd Ste 100 Alpharetta GA 30004-6377 | |
| (770) 526-0190 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12455 Broadwell Rd Ste 100, Alpharetta, Georgia |
| Authorized Official Name and Position | Korry Tauber (OWNER, ORTHODONTIST) |
| Authorized Official Contact | 7705260190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12455 Broadwell Rd Ste 100 Alpharetta GA 30004-6315 Ph: () - | 12455 Broadwell Rd Ste 100 Alpharetta GA 30004-6377 Ph: (770) 526-0190 |
| NPI Number | 1013787597 |
|---|---|
| Provider Enumeration Date | 01/04/2024 |
| Last Update Date | 07/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013787597 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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