Pediatric Dental Specialist Of Hiram

NPI 1245617364 - Dentist - 1223P0221X

NPI Details
NPI 1245617364
Enumeration Date 04/27/2015
Last Updated 04/27/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name MINDY LYNN MINDY
Position PRESIDENT
Phone (770) 943-0011
Fax
Practice Location
5604 WENDY BAGWELL PKWY
SUITE 1100
HIRAM GA, 30141-7813, US
Phone (770) 943-0011
Fax
Business Location
5604 WENDY BAGWELL PKWY
SUITE 1100
HIRAM GA, 30141-7813, US
Phone (770) 943-0011
Fax
Toxanomy
Taxonomy Code 1223P0221X
License State Georgia
License Number DN013367
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According to our database, Pediatric Dental Specialist Of Hiram NPI is 1245617364, taxonomy code is 1223P0221X and license number is DN013367, license state is located at Georgia. Pediatric Dental Specialist Of Hiram physically located at 5604 Wendy Bagwell Pkwy, Hiram GA, 30141-7813. NPI Number 1033115704 has the healthcare provider type.

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1245617364 NPI number is provided on an as is basis without warranty of any kind. 1245617364 is maintained by the National Plan & Provider Enumeration System. The contents of Pediatric Dental Specialist Of Hiram are for informational purposes only.