Organization
MAIN STREET DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMAD SABBAGH DDS (PRESIDENT CEO)
(770) 475-6136
Entity
Organization
Contact information
Practice address
366 NORTH MAIN STREET, SUITE 200, ALPHARETTA, GA 30004
(770) 475-6136
(770) 475-5037
Mailing address
366 NORTH MAIN STREET, SUITE 200, ALPHARETTA, GA 30004
(770) 475-6136
(770) 475-5037
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11529
GA
Other
Enumeration date
11/07/2006
Last updated
08/22/2020
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