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Organization

PEDIATRIC SEDATION CENTER OF GA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SERENTHES FIELDS (CREDENTIALING SPECIALIST)
(678) 599-2333
Entity
Organization

Contact information

Practice address
8180 MALL PKWY STE 810, LITHONIA, GA 30038-6911
(470) 395-2518
(470) 243-7395
Mailing address
8180 MALL PKWY STE 810, LITHONIA, GA 30038-6911
(470) 395-2518
(470) 243-7395

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
09/19/2022
Last updated
11/28/2022
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