Organization
BELLA DENTAL SERVICES, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODERICK SAMPSON COOPER D.D.S. (OWNER/DENTIST)
(404) 294-8385
Entity
Organization
Contact information
Practice address
4122 E PONCE DE LEON AVE, SUITE #5, CLARKSTON, GA 30021-1838
(404) 294-8385
Mailing address
4122 E PONCE DE LEON AVE, SUITE #5, CLARKSTON, GA 30021
(404) 294-8385
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DNO13198
GA
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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