Organization
99 MOCKINGBIRD DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH STEPHENS DMD (DOCTOR/OWNER)
(912) 580-8511
Entity
Organization
Contact information
Practice address
99 MOCKINGBIRD DR, CARTERSVILLE, GA 30120-2826
(770) 386-3908
Mailing address
117 NORTHAMPTON DR, CANTON, GA 30115-6015
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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