Organization
PEARLS OF HEALTH MEDICAL AND DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE KAREN NICOME MD (MEMBER/MANAGER)
(770) 306-4457
Entity
Organization
Contact information
Practice address
7580 SPRINGBOX DR, SUITE 250, FAIRBURN, GA 30213-1287
(770) 306-4457
(770) 774-7218
Mailing address
7580 SPRINGBOX DR, SUITE 250, FAIRBURN, GA 30213-1287
(770) 306-4457
(770) 774-7218
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
12/29/2011
Last updated
12/20/2012
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