Organization
STONE MOUNTAIN DENTAL 2, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NIKKI ROLLS (PRACTICE ADMINISTRATOR)
(404) 452-1164
Entity
Organization
Contact information
Practice address
3100 FIVE FORKS TRICKUM RD SW STE 402, LILBURN, GA 30047-1887
(770) 837-9832
(404) 445-8499
Mailing address
3100 FIVE FORKS TRICKUM RD SW STE 402, LILBURN, GA 30047-1887
(770) 837-9832
(404) 445-8499
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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