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General NPI Number Information
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NPI Number | 1699200774
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Entity Type | Organization
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Legal Business Name | AMON MEADOWS DMD PC
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 04/26/2017
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Provider Practice Location Address
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Address Line | 4687 S ATLANTA RD SE SUITE 214
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City | VININGS
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State | GA
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Zip | 30339-1509
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Country | US
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Telephone | 404-799-8499
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Fax |
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Provider Business Mailing Address
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Address Line | 4687 S ATLANTA RD SE SUITE 214
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City | VININGS
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State | GA
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Zip | 30339-1509
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Country | US
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Telephone | 404-799-8499
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMON A MEASOWS
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Credential | DMD
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Telephone | 404-799-8499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN011763
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License Number State | GA
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