Organization
EAST COBB DENTISTRY FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON K ALLEN D.D.S. (PEDIATRIC DENTISTRY)
(678) 813-2388
Entity
Organization
Contact information
Practice address
2880 JOHNSON FERRY RD, MARIETTA, GA 30062-8368
(678) 813-2388
Mailing address
2880 JOHNSON FERRY RD, MARIETTA, GA 30062-8368
(678) 813-2388
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DNO13148
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
896892351AB
—
GA
Enumeration date
05/29/2014
Last updated
05/29/2014
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