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Organization
METRO DECATUR DENTAL GROUP
Active
Organization
METRO DECATUR DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY SIMMS D.M.D. (DENTIST)
(404) 292-3133
Entity
Organization
Contact information
Practice address
4570 MEMORIAL DR, DECATUR, GA 30032-1447
(404) 292-3133
(404) 935-0905
Mailing address
4570 MEMORIAL DR, DECATUR, GA 30032-1447
(404) 292-3133
(404) 935-0905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013291
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
694565025A
—
GA
Enumeration date
09/13/2008
Last updated
09/13/2008
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