Organization
SPECIALTY PROVIDERS AT CHILDREN'S, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE CAVASIN (MANAGER PROVIDER ENROLLMENT)
(404) 785-5869
Entity
Organization
Contact information
Practice address
1575 NORTHEAST EXPY NE, BROOKHAVEN, GA 30329-2401
(404) 785-7876
Mailing address
1575 NORTHEAST EXPY NE, BROOKHAVEN, GA 30329-2401
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/11/2016
Last updated
10/17/2025
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