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Organization

EASTSIDE DENTAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DEJUANQUARIES STEPHENS DMD (OWNER)
(770) 559-6202
Entity
Organization

Contact information

Practice address
2055 BEAVER RUIN RD STE E, NORCROSS, GA 30071-3786
(770) 559-6202
Mailing address
2055 BEAVER RUIN RD STE E, NORCROSS, GA 30071-3786
(770) 559-6202

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/13/2024
Last updated
12/13/2024
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