Organization
PREMIER DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLE DENISE GREENE DDS (PRESIDENT)
(404) 915-1666
Entity
Organization
Contact information
Practice address
8097 ROSWELL RD, BLDG E, ATLANTA, GA 30350-6159
(770) 642-4711
Mailing address
8097 ROSWELL RD, BLDG E, ATLANTA, GA 30350-6159
(770) 642-4711
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011973
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00814965C
—
GA
Enumeration date
04/03/2008
Last updated
04/03/2008
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