Organization
PROVIDENCE DENTAL SPA OF EAST COBB, LLC
Active
Parent organization
PROVIDENCE DENTAL LLC
Other names
Providence Dental Spa of East Cobb
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE DENTAL LLC
Authorized official
HEATHER TAYLOR (DIRECTOR)
(470) 309-8888
Entity
Organization
Contact information
Practice address
670 JOHNSON FERRY RD, MARIETTA, GA 30068-4627
(678) 801-6700
Mailing address
670 JOHNSON FERRY RD, MARIETTA, GA 30068-4627
(678) 801-6700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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