Organization
HOMEGROWN PEDIATRIC DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MCKELLAR (MEMBER/ PEDIATRIC DENTIST)
(386) 212-6669
Entity
Organization
Contact information
Practice address
405 ARROWHEAD BLVD, JONESBORO, GA 30236-1254
(770) 471-1991
Mailing address
1005 TIMBER LAKE DR, CUMMING, GA 30041-8606
(386) 212-6669
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN014531
GA
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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