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Organization
EXECUTIVE PARK DENTISTRY, P.C.
Active
Organization
EXECUTIVE PARK DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR S DAMJI (OWNER/DENTIST)
(404) 664-6876
Entity
Organization
Contact information
Practice address
17 EXECUTIVE PARK DR NE, SUITE 100, ATLANTA, GA 30329-2251
(404) 633-0715
Mailing address
17 EXECUTIVE PARK DR NE, SUITE 100, ATLANTA, GA 30329-2251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012967
GA
Other
Enumeration date
07/16/2012
Last updated
07/16/2012
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