Healthcare Provider Details

I. General information

NPI: 1528107984
Provider Name (Legal Business Name): PRIEST & SMITH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 PEACHTREE ST NE SUITE 795
ATLANTA GA
30309-3915
US

IV. Provider business mailing address

999 PEACHTREE ST NE SUITE 795
ATLANTA GA
30309-3915
US

V. Phone/Fax

Practice location:
  • Phone: 404-872-3140
  • Fax: 404-872-3177
Mailing address:
  • Phone: 404-872-3140
  • Fax: 404-872-3177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number9003
License Number StateGA

VIII. Authorized Official

Name: MRS. KIM COLLETT
Title or Position: OFFICE MANAGER
Credential:
Phone: 404-872-3140