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Organization
CASSANDRA G. BRACKETT, D.D.S.,P.C.
Active
Organization
CASSANDRA G. BRACKETT, D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CASSANDRA G. BRACKETT D.D.S. (CEO)
(404) 289-3060
Entity
Organization
Contact information
Practice address
3300 MEMORIAL DR, SUITE D-3, DECATUR, GA 30032-2700
(404) 289-3060
(404) 288-6080
Mailing address
3300 MEMORIAL DR, SUITE D-3, DECATUR, GA 30032-2700
(404) 289-3060
(404) 288-6080
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0010117
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000310318C
—
GA
Enumeration date
10/07/2009
Last updated
10/07/2009
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