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Organization
SOUTHERN SMILES DENTISTRY CUMMING PC
Active
Organization
SOUTHERN SMILES DENTISTRY CUMMING PC
Active
Other names
Sharon Springs Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL RICHTER RDH (OFFICE MANAGER)
(470) 253-1747
Entity
Organization
Contact information
Practice address
1475 PEACHTREE PKWY STE C3, CUMMING, GA 30041-9793
(470) 253-1747
Mailing address
1475 PEACHTREE PKWY STE C3, CUMMING, GA 30041-9793
(470) 253-1747
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225310592
PPO
GA
Enumeration date
06/28/2021
Last updated
06/28/2021
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