# MIDTOWN DENTAL STUDIO LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174868905
- **Authorized official:** DR. TRAVON J HOLT (CEO/DENTIST)
- **Authorized official phone:** (404) 937-6940

## Contact information

- **Practice address:** 197 14TH ST NW, SUITE 101, ATLANTA, GA 30318-7815
- **Practice address phone:** (404) 937-6940
- **Mailing address:** 197 14TH ST NW, SUITE 101, ATLANTA, GA 30318-7815
- **Mailing address phone:** (404) 937-6940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2012
- **Last updated:** 12/05/2012