| Tebo Dentistry For Kids Marietta Llc | |
|
2155 Post Oak Tritt Rd Suite 450 Marietta GA 30062-8620 | |
| (770) 925-3300 | |
| Not Available |
| Full Name | Tebo Dentistry For Kids Marietta Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2155 Post Oak Tritt Rd, Marietta, Georgia |
| Authorized Official Name and Position | Mark Denny Thebaut (PRESIDENT/OWNER) |
| Authorized Official Contact | 7709253300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tebo Dentistry For Kids Marietta Llc Po Box 1953 Lilburn GA 30048-1953 Ph: () - | Tebo Dentistry For Kids Marietta Llc 2155 Post Oak Tritt Rd Suite 450 Marietta GA 30062-8620 Ph: (770) 925-3300 |
| NPI Number | 1396106142 |
|---|---|
| Provider Enumeration Date | 03/08/2016 |
| Last Update Date | 03/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396106142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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