Organization
ADVANCED DENTAL IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN T SPILLANE DMD (OWNER)
(770) 928-4747
Entity
Organization
Contact information
Practice address
335 PARKWAY 575 STE 200, WOODSTOCK, GA 30188-3878
(770) 928-4747
Mailing address
335 PARKWAY 575 STE 200, WOODSTOCK, GA 30188-3878
(770) 928-4747
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
10246
GA
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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