MEDICARE: BYRD DENTAL GROUP AT NORTH POINT, P.C.

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	122300000X	Dentist	GA-012070	GA

General Provider Information

NPI Number	:	1548417314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BYRD DENTAL GROUP AT NORTH POINT, P.C.

Provider Business Mailing Address
First Line	:	4000 N POINT PKWY
Second Line	:	SUITE 500-600
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-8801
Country	:	US
Telephone Number	:	770-777-0911
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 N POINT PKWY
Second Line	:	SUITE 500-600
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-8801
Country	:	US
Telephone Number	:	770-777-0911
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. TIMOTHY NATHAN BYRD
Credential	:	DMD
Telephone Number	:	770-777-0911

Provider Enumeration Date	:	08/25/2008
Last Update Date	:	10/16/2008

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