Organization
DENTFIRST, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA S JACKSON (CONTRACTS, CRED & BENEFITS MGR)
(770) 446-8000
Entity
Organization
Contact information
Practice address
530 17TH ST NW STE 340, ATLANTA, GA 30318-5037
(404) 975-1735
(678) 701-3305
Mailing address
1650 OAKBROOK DR STE 440, NORCROSS, GA 30093-1817
(770) 446-8000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
03/27/2019
Last updated
03/28/2019
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