Organization
LITHONIA PEDIATRIC DENTISTRY-STONECREST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOUNG TAE SHIM D.M.D. (DENTIST)
(770) 482-4661
Entity
Organization
Contact information
Practice address
7215 STONECREST PKWY, LITHONIA, GA 30038-2563
(770) 482-4661
(770) 482-4606
Mailing address
7215 STONECREST PKWY, LITHONIA, GA 30038-2563
(770) 482-4661
(770) 482-4606
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013999
GA
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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