Modern Dental Center
Durable Medical Equipment & Medical Supplies, Customized Equipment in Marietta, GA. Organization (NPI-2).
NPI number1093563751
StatusActive
Last updated in NPPESSep 25, 2024
Details
- NPI
- 1093563751
- Entity type
- Organization (NPI-2)
- Legal business name
- Modern Dental Center
- Organization subpart
- No
- Enumeration date
- May 8, 2024
- Certification date
- Sep 25, 2024
- Last updated
- Sep 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332BC3200X | Durable Medical Equipment & Medical Supplies, Customized Equipment | – | – | Yes |
Practice location
4608 Lower Roswell RdMarietta, GA 30068-4237
Phone 770-615-6510 · Fax 770-615-6511
Mailing address
4608 Lower Roswell RdMarietta, GA 30068-4237
Phone 770-615-6510
Authorized official
Marianna Kovitch
Dentist/Owner
7706156510
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