Organization
DENTURES AND FAMILY DENTISTRY
Active
Other names
Smiles At Stone Mountain Festival
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMIE LEE BLOUNT DDS (OWNER/ DOCTOR)
(770) 482-7800
Entity
Organization
Contact information
Practice address
1825 ROCKBRIDGE RD, SUITE 14 C, STONE MOUNTAIN, GA 30087-3335
(678) 672-2720
(678) 672-2722
Mailing address
1825 ROCKBRIDGE RD, SUITE 14 C, STONE MOUNTAIN, GA 30087-3335
(770) 482-7800
(770) 482-7830
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
DN11497
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000749504A
—
GA
Enumeration date
10/27/2009
Last updated
07/30/2010
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