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General NPI Number Information
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NPI Number | 1134502099
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Entity Type | Organization
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Legal Business Name | ATLANTA SMILES & WELLNESS LLC
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 4405 NORTHSIDE PKWY NW STE 110
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City | ATLANTA
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State | GA
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Zip | 30327-5221
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Country | US
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Telephone | 404-262-7733
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Fax | 404-262-1023
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Provider Business Mailing Address
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Address Line | 4405 NORTHSIDE PKWY NW STE 110
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City | ATLANTA
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State | GA
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Zip | 30327-5221
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Country | US
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Telephone | 404-262-7733
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Fax | 404-262-1023
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Authorized Official
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Title or Position | OWNER
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Name | DR. DINA J GIESLER
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Credential | DDS,MAGD
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Telephone | 404-262-7733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DNO14252
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11662
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License Number State | GA
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