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General NPI Number Information
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NPI Number | 1952969396
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Entity Type | Organization
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Legal Business Name | NS3 SERVICES, LLC
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 1039 GRANT ST SE STE B11
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City | ATLANTA
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State | GA
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Zip | 30315-2050
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Country | US
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Telephone | 470-747-7888
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Fax | 470-747-7999
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Provider Business Mailing Address
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Address Line | 1039 GRANT ST SE STE B11
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City | ATLANTA
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State | GA
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Zip | 30315-2050
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Country | US
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Telephone | 470-747-7888
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Fax | 470-747-7999
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Authorized Official
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Title or Position | CEO
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Name | NIKKY SHOTWELL
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Credential | DDS
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Telephone | 470-747-7888
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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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