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207 Sw Upper Riverdale Road Riverdale GA 30274-2537 | |
| (770) 751-8887 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 207 Sw Upper Riverdale Road, Riverdale, Georgia |
| Authorized Official Name and Position | Eugene N Witkin (DDS/OWNER) |
| Authorized Official Contact | 7707518887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
207 Upper Riverdale Rd Sw Riverdale GA 30274-2537 Ph: (770) 751-8887 | 207 Sw Upper Riverdale Road Riverdale GA 30274-2537 Ph: (770) 751-8887 |
| NPI Number | 1134223696 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134223696 | NPI | - | NPPES |
| 00969724E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 009491 (Georgia) | Primary |
Smiles Dental Lab, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6030 Highway 85 Ste 240, Riverdale, GA 30274 Phone: 770-996-5737 Fax: 770-996-5916 | |
Daniel Redie General Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1849 Highway 138 Sw, Riverdale, GA 30296 Phone: 770-996-5850 | |