Organization
JUST KIDS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARITA HENRY (OWNER)
(770) 972-0921
Entity
Organization
Contact information
Practice address
1350 SCENIC HWY N, SUITE 262, SNELLVILLE, GA 30078-7907
(770) 972-0921
(770) 972-0922
Mailing address
1350 SCENIC HWY N, SUITE 262, SNELLVILLE, GA 30078-7907
(770) 972-0921
(770) 972-0922
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000900974D
—
GA
01
—
188040
DORAL DENTAL
GA
Enumeration date
07/02/2009
Last updated
01/22/2010
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