MEDICARE: DR. JANET MAURITA STILES D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	8453	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255400214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET MAURITA STILES D.D.S.

Provider Business Mailing Address
First Line	:	75 PIEDMONT AVE
Second Line	:	SUITE 1166
City	:	ATLANTA
State	:	GA
Zip	:	30303-2507
Country	:	US
Telephone Number	:	404-688-5668
Fax Number	:	404-584-2824

Provider Business Practice Location Address
First Line	:	75 PIEDMONT AVE
Second Line	:	SUITE 1166
City	:	ATLANTA
State	:	GA
Zip	:	30303-2507
Country	:	US
Telephone Number	:	404-688-5668
Fax Number	:	404-584-2824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/09/2007

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