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General NPI Number Information
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NPI Number | 1346538048
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Entity Type | Organization
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Legal Business Name | MIDTOWN SMILE CENTER
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Dates
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Enumeration Date | 07/14/2011
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 999 PEACHTREE ST SUITE 700
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City | ATLANTA
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State | GA
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Zip | 30309-3915
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Country | US
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Telephone | 404-537-5224
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Fax | 404-537-5219
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Provider Business Mailing Address
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Address Line | 999 PEACHTREE ST SUITE 700
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City | ATLANTA
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State | GA
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Zip | 30309-3915
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Country | US
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Telephone | 404-537-5224
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Fax | 404-537-5219
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Authorized Official
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Title or Position | INSURANCE COORDINATOR
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Name | GERALD LAMAR ALLEN
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Credential |
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Telephone | 678-399-8473
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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 |
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License Number State | GA
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