Organization
MUCCIOLI DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY EARL MUCCIOLI D.M.D (OWNER/DENTIST)
(678) 389-9955
Entity
Organization
Contact information
Practice address
6300 HOSPITAL PKWY, SUITE 275, JOHNS CREEK, GA 30097-1828
(678) 389-9955
(678) 389-9952
Mailing address
6300 HOSPITAL PKWY, SUITE 275, JOHNS CREEK, GA 30097-1828
(678) 389-9955
(678) 389-9952
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014378
GA
1223P0700X
Prosthodontics
DN014379
GA
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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