Organization
OLD MILTON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COREY J MAZER DDS (OWNER)
(678) 624-0370
Entity
Organization
Contact information
Practice address
4165 OLD MILTON PKWY, SUITE 190, ALPHARETTA, GA 30005-4468
(678) 624-0370
(678) 624-0319
Mailing address
4165 OLD MILTON PKWY, SUITE 190, ALPHARETTA, GA 30005-4468
(678) 624-0370
(678) 624-0319
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
012287
GA
122300000X
Dentist
012301
GA
Other
Enumeration date
04/25/2007
Last updated
08/22/2020
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