Organization
HAMMOND DENTAL SANDY SPRINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICAJAH JON VICKERS (LLC MANAGER)
(404) 432-9922
Entity
Organization
Contact information
Practice address
227 SANDY SPRINGS PL STE 352, SANDY SPRINGS, GA 30328-5918
(404) 531-2003
Mailing address
3535 PEACHTREE RD NE STE 520-176, ATLANTA, GA 30326-3287
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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