Organization
GEORGIA DENTAL ALLIANCE OF CARTERSVILLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER SIMS (CREDENTIALING SPECIALIST)
(470) 552-1823
Entity
Organization
Contact information
Practice address
650 HENDERSON DR STE 205, CARTERSVILLE, GA 30120-3756
(770) 387-4533
(770) 387-4531
Mailing address
650 HENDERSON DR STE 205, CARTERSVILLE, GA 30120-3756
(770) 387-4533
(770) 387-4531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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