Organization
MARIETTA SMILE GALLERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL THOMAS JR. DMD, FAGD (OWNER)
(706) 466-1796
Entity
Organization
Contact information
Practice address
3535 ROSWELL RD STE 3, MARIETTA, GA 30062-8827
(770) 627-5598
Mailing address
3535 ROSWELL RD STE 3, MARIETTA, GA 30062-8827
(770) 627-5598
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN014649
GA
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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