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Superior Dental Of East Cobb, LLC

Dentist, General Practice in Marietta, GA. Organization (NPI-2).

NPI number1982102653
StatusActive
Last updated in NPPESJan 29, 2018

Details

NPI
1982102653
Entity type
Organization (NPI-2)
Legal business name
Superior Dental Of East Cobb, LLC
Organization subpart
No
Enumeration date
Jan 29, 2018
Last updated
Jan 29, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeDN012980GAYes

Practice location

2745 Sandy Plains Rd Ste 118
Marietta, GA 30066-4327

Phone 770-977-1611

Mailing address

347 Lightburn Crk Nw
Marietta, GA 30064-1307

Phone 678-977-8119

Authorized official

Bobby T Shirley
Owner
6789778119

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