Chastain Park Dentistry, PC
Dentist, General Practice in Sandy Springs, GA. Organization (NPI-2).
NPI number1902266638
StatusActive
Last updated in NPPESFeb 23, 2016
Details
- NPI
- 1902266638
- Entity type
- Organization (NPI-2)
- Legal business name
- Chastain Park Dentistry, PC
- Organization subpart
- No
- Enumeration date
- Feb 23, 2016
- Last updated
- Feb 23, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Chastain Park Dentistry (Doing Business As)
Practice location
4600 Roswell RdSuite C120
Sandy Springs, GA 30342-3075
Phone 404-341-9593 · Fax 404-418-4543
Mailing address
17000 Red Hill AveIrvine, CA 92614-5626
Phone 714-845-8890 · Fax 949-474-1495
Authorized official
Katie L Mccann
Owner
4043419593
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