Organization
PONCE DENTAL STUDIO BUCKHEAD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CRAWFORD (ADMINISTRATIVE SUPPORT)
(321) 750-9537
Entity
Organization
Contact information
Practice address
3189 MAPLE DR NE, ATLANTA, GA 30305-2501
(404) 383-1111
Mailing address
3189 MAPLE DR NE, ATLANTA, GA 30305-2501
(404) 383-1111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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