Organization
ATLANTA DENTAL TEAM STONE MOUNTAIN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREN A OWENS DDS (OWNER)
(770) 469-1331
Entity
Organization
Contact information
Practice address
1000 MAIN ST, SUITE F, STONE MOUNTAIN, GA 30083-2978
(770) 469-1331
Mailing address
1000 MAIN ST, SUITE F, STONE MOUNTAIN, GA 30083-2978
(770) 469-1331
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12130GA
GA
122300000X
Dentist
DN09316
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000386625A
—
GA
Enumeration date
02/15/2012
Last updated
08/01/2012
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