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Organization

EAST COBB NIA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SARA SEBASTIAN (BILLING/INSURANCE MANAGER)
(770) 479-9999
Entity
Organization

Contact information

Practice address
1111 JOHNSON FERRY RD, MARIETTA, GA 30068-2181
(770) 479-9999
Mailing address
1111 JOHNSON FERRY RD, MARIETTA, GA 30068
(770) 479-9999

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013543
GA

Other

Enumeration date
10/13/2016
Last updated
03/08/2017
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