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General NPI Number Information
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NPI Number | 1841454329
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Entity Type | Organization
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Legal Business Name | MARTIN P KRIEGER DDS AND ASSOCIATES
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 810 CANTON RD NE SUITE D
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City | MARIETTA
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State | GA
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Zip | 30060-8953
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Country | US
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Telephone | 770-422-8264
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Fax | 770-422-4051
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Provider Business Mailing Address
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Address Line | 810 CANTON RD NE SUITE D
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City | MARIETTA
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State | GA
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Zip | 30060-8953
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Country | US
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Telephone | 770-422-8264
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Fax | 770-422-4051
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SUSAN JEAN CHAMBERS
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Credential |
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Telephone | 770-422-8264
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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 | DN008049
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License Number State | GA
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