Organization
MH DENTAL PC
Active
Other names
Vital Smiles Georgia
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL G. WALKER (COLLECTIONS MANAGER)
(770) 367-8389
Entity
Organization
Contact information
Practice address
6000 SINGLETON RD, STE 315, NORCROSS, GA 30093
(770) 248-9029
(770) 248-9130
Mailing address
1030A WEST GORDON AVE, ALBANY, GA 31701
(770) 248-9029
(770) 248-9130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714338776B
—
GA
Enumeration date
04/20/2007
Last updated
07/24/2012
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