Organization
PAUL IVEY NETTLES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL I NETTLES DMD (PRESIDENT)
(770) 997-9090
Entity
Organization
Contact information
Practice address
1177 GARDEN WALK BLVD, COLLEGE PARK, GA 30349-6245
(770) 997-9090
Mailing address
730 HIGHMEADE TER, ALPHARETTA, GA 30005-3755
(770) 337-0976
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11589
GA
1223P0221X
Pediatric Dentistry
Primary
6742
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050949A
—
GA
Enumeration date
01/18/2007
Last updated
09/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us