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General NPI Number Information
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NPI Number | 1174790331
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Entity Type | Organization
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Legal Business Name | ROSWELL URGENT CARE CENTER LLC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 660 W CROSSVILLE RD SUITE 110
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City | ROSWELL
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State | GA
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Zip | 30075-7525
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Country | US
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Telephone | 770-992-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 660 W CROSSVILLE RD SUITE 110
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City | ROSWELL
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State | GA
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Zip | 30075-7525
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Country | US
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Telephone | 770-992-4700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUDITH DENNIS
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Credential | MD
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Telephone | 770-317-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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