Organization
FABULOUS SMILES OF LILBURN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI ROLLS (OFFICE MANAGER)
(770) 557-0788
Entity
Organization
Contact information
Practice address
331 ARCADO RD NW, LILBURN, GA 30047-3077
(770) 557-0788
(404) 420-2951
Mailing address
331 ARCADO RD NW, LILBURN, GA 30047-3077
(770) 557-0788
(404) 420-2951
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
DN011973
GA
Other
Enumeration date
07/21/2015
Last updated
07/21/2015
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