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General NPI Number Information
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NPI Number | 1518856939
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Entity Type | Organization
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Legal Business Name | D&S PEDIATRIC DENTAL SPECIALISTS, LLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 5915 E LAKE PKWY STE 200
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City | MCDONOUGH
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State | GA
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Zip | 30253-4830
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Country | US
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Telephone | 470-660-5380
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Fax |
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Provider Business Mailing Address
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Address Line | 1081 JUNIPER ST NE APT 2508
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City | ATLANTA
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State | GA
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Zip | 30309
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Country | US
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Telephone | 678-525-0016
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. DARIUS SANFORD
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Credential | DMD
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Telephone | 678-525-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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