Healthcare Provider Details

I. General information

NPI: 1770830689
Provider Name (Legal Business Name): DENTFIRST, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 LENOX RD. NE
ATLANTA GA
30328
US

IV. Provider business mailing address

1650 OAKBROOK DR SUITE 440
NORCROSS GA
30093
US

V. Phone/Fax

Practice location:
  • Phone: 404-325-9000
  • Fax: 770-446-1354
Mailing address:
  • Phone: 770-446-8000
  • Fax: 770-446-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7981
License Number StateGA

VIII. Authorized Official

Name: MRS. VALENCIA J WARNER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 770-446-8000