Organization
SANDY SPRINGS DENTAL 2 LLC
Active
Other names
Sandy Springs Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MICAJAH J VICKERS (MEMBER)
(404) 432-9922
Entity
Organization
Contact information
Practice address
6100 LAKE FORREST DR STE 110, ATLANTA, GA 30328-3835
(404) 252-7373
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
10/27/2023
Last updated
10/27/2023
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