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Atlanta West Periodontics And Dental Implants PC

Dentist in Lithia Springs, GA. Organization (NPI-2).

NPI number1700977360
StatusActive
Last updated in NPPESMar 7, 2023

Details

NPI
1700977360
Entity type
Organization (NPI-2)
Legal business name
Atlanta West Periodontics And Dental Implants PC
Organization subpart
No
Enumeration date
Sep 27, 2006
Last updated
Mar 7, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist10752GAYes
122300000X Dentist2901016263MI

Practice location

2168 Skyview Drive
Lithia Springs, GA 30122

Phone 770-739-5097 · Fax 770-739-0517

Mailing address

2168 Skyview Drive
Lithia Springs, GA 30122

Phone 770-739-5097 · Fax 770-739-0517

Authorized official

Cheryl Lynn Cushman
Owner Ceo
7707395097

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