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1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6405 | |
| (770) 916-5031 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1090 Northchase Pkwy Se, Marietta, Georgia |
| Authorized Official Name and Position | Dimetry Cossich (PRESIDENT) |
| Authorized Official Contact | 5043615333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1708 Manhattan Blvd Suite C Harvey LA 70058-3400 Ph: (504) 361-5333 | 1090 Northchase Pkwy Se Ste 150 Marietta GA 30067-6405 Ph: (770) 916-5031 |
| NPI Number | 1750750360 |
|---|---|
| Provider Enumeration Date | 09/24/2015 |
| Last Update Date | 09/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750750360 | NPI | - | NPPES |
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