MEDICARE: BEST CARE DENTAL INC.

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	DN011798	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548339575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEST CARE DENTAL INC.

Provider Business Mailing Address
First Line	:	3700 MARKET ST STE A2
Second Line	:
City	:	CLARKSTON
State	:	GA
Zip	:	30021-2652
Country	:	US
Telephone Number	:	404-298-3258
Fax Number	:	404-298-7543

Provider Business Practice Location Address
First Line	:	3700 MARKET ST STE A2
Second Line	:
City	:	CLARKSTON
State	:	GA
Zip	:	30021-2652
Country	:	US
Telephone Number	:	404-298-3258
Fax Number	:	404-298-7543

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CALVERT HARRISON
Credential	:
Telephone Number	:	678-463-0063

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	03/14/2012

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Directions to “BEST CARE DENTAL INC. ” Practice Location

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