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Organization

HALLMARK DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEANETTE M YOUNG DDS (OWNER/DENTIST)
(678) 355-0222
Entity
Organization

Contact information

Practice address
1600 KENNESAW DUE WEST RD NW, 305-306, KENNESAW, GA 30152-4301
(678) 355-0222
(678) 355-1060
Mailing address
1600 KENNESAW DUE WEST RD NW, 305-306, KENNESAW, GA 30152-4301
(678) 355-0222
(678) 355-1060

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014390
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003140747A
GA
01
1396074589
NPPES
GA
Enumeration date
11/17/2014
Last updated
11/17/2014
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