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NPI Code Detail

MEDICARE: SUSAN GOODE ESTEP D.M.D.

MEDICARE: SUSAN GOODE ESTEP 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 DentistryDN012382GA

General Provider Information

NPI Number : 1780759845
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN GOODE ESTEP D.M.D.
Provider Business Mailing Address
First Line : 950 W PEACHTREE ST NW
Second Line : SUITE 245
City : ATLANTA
State : GA
Zip : 30309-3846
Country : US
Telephone Number : 404-381-8586
Fax Number :
Provider Business Practice Location Address
First Line : 950 W PEACHTREE ST NW
Second Line : SUITE 245
City : ATLANTA
State : GA
Zip : 30309-3846
Country : US
Telephone Number : 404-381-8586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 09/08/2016

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