Organization
FREEDOM 11, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL REZNIK (OWNER)
(404) 307-0358
Entity
Organization
Contact information
Practice address
3840 PEACHTREE INDUSTRIAL BLVD, 320, DULUTH, GA 30096
(770) 670-6555
Mailing address
3840 PEACHTREE INDUSTRIAL BLVD, 320, DULUTH, GA 30096
(770) 670-6555
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8077
GA
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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