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NPI Code Detail

MEDICARE: DR. JAIME LAUREN STEWART D.M.D.

MEDICARE: DR. JAIME LAUREN STEWART D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN013993GA

General Provider Information

NPI Number : 1700112380
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAIME LAUREN STEWART D.M.D.
Provider Business Mailing Address
First Line : 2969 JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30062-5653
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2969 JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30062-5653
Country : US
Telephone Number : 770-992-2340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2009
Last Update Date : 04/30/2013

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