Organization
AVALA DENTAL PROVIDERS
Active
Parent organization
COMFORT DENTAL LOUNGE
Other names
comfort dental lounge
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMFORT DENTAL LOUNGE
Authorized official
DR. TIFFANY NICOLE JAMISON DDS (MANAGER)
(202) 714-8433
Entity
Organization
Contact information
Practice address
5495 JIMMY CARTER BLVD., SUITE A-14, NORCROSS, GA 30093
(770) 368-9159
(770) 368-9119
Mailing address
5495 JIMMY CARTER BLVD., SUITE A-14, NORCROSS, GA 30093
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014034
GA
Other
Enumeration date
03/24/2011
Last updated
01/22/2013
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