MEDICARE: DAHLIA LEVINE

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
1	1223G0001X	General Practice Dentistry	DN015766	GA

General Provider Information

NPI Number	:	1790282341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAHLIA LEVINE

Provider Business Mailing Address
First Line	:	OVERLOOK 3 BUILDING
Second Line	:	2859 PACES FERRY ROAD SE SUITE 530
City	:	ATLANTA
State	:	GA
Zip	:	30339
Country	:	US
Telephone Number	:	679-355-8980
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ROSWELL RD STE 55
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8828
Country	:	US
Telephone Number	:	770-321-5558
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2018
Last Update Date	:	01/17/2025

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Directions to “ DAHLIA LEVINE ” Practice Location

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