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Organization
SMILE 23 GEORGIA LLC
Active
Organization
SMILE 23 GEORGIA LLC
Active
Other names
Buckhead Periodontics P.C., Buckhead Periodontics, Buckhead Specialty Group
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR BRYAN TUNE (CDO)
(636) 233-1882
Entity
Organization
Contact information
Practice address
3280 HOWELL MILL RD NW STE 331, ATLANTA, GA 30327-4109
(404) 261-9593
Mailing address
3280 HOWELL MILL RD NW STE 331, ATLANTA, GA 30327-4109
(404) 261-9593
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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