MEDICARE: CAMP CREEK SMILES

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	121923LGB	GA

General Provider Information

NPI Number	:	1922195155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMP CREEK SMILES

Provider Business Mailing Address
First Line	:	3890 REDWINE RD SW
Second Line	:	SUITE 108
City	:	ATLANTA
State	:	GA
Zip	:	30331-5509
Country	:	US
Telephone Number	:	404-344-7645
Fax Number	:	404-574-6725

Provider Business Practice Location Address
First Line	:	3890 REDWINE RD SW
Second Line	:	SUITE 108
City	:	ATLANTA
State	:	GA
Zip	:	30331-5509
Country	:	US
Telephone Number	:	404-344-7645
Fax Number	:	404-574-6725

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ERICKA EDMONDS
Credential	:	DDS
Telephone Number	:	404-344-7645

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1588659908 — DR. DARA PAUL MD
Practice Location Address:

3890 REDWINE RD SW , STE 210
ATLANTA, GA
30331-5509

Practice Phone: 404-346-3417
Practice Fax: 404-346-3418

1083665491 — DR. NITASHA LARISMA BURNEY MD
Practice Location Address:

3890 REDWINE RD SW , SUITE 104
ATLANTA, GA
30331-5509

Practice Phone: 404-629-9495
Practice Fax: 404-629-9498

1255354122 — CAMP CREEK WOMEN'S HEALTH SPECIALIST
Practice Location Address:

3890 REDWINE RD SW STE 106
ATLANTA, GA
30331-5509

Practice Phone: 404-344-2229
Practice Fax: 404-574-6715

1861503906 — CAMP CREEK PRIMARY CARE, PC
Practice Location Address:

3890 REDWINE RD SW , SUITE 100
ATLANTA, GA
30331-5509

Practice Phone: 404-349-2273
Practice Fax: 404-349-1511

1922150226 — CHILDREN'S DENTISTRY OF CAMP CREEK
Practice Location Address:

3890 REDWINE RD SW
ATLANTA, GA
30331-5509

Practice Phone: 404-344-7900
Practice Fax:

1689728685 — ATLANTA WOMEN'S MEDICAL CTR., INC
Practice Location Address:

3890 REDWINE RD SW , SUITE 210
ATLANTA, GA
30331-5509

Practice Phone: 404-346-3417
Practice Fax: 404-346-3418

Directions to “CAMP CREEK SMILES ” Practice Location

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