Organization
SOUTH HAIRSTON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER ALLEN D.D.S. (DENTIST)
(404) 294-3600
Entity
Organization
Contact information
Practice address
1234 S HAIRSTON RD, SUITE 23, STONE MOUNTAIN, GA 30088-2749
(404) 294-3600
Mailing address
1234 S HAIRSTON RD, SUITE 23, STONE MOUNTAIN, GA 30088-2749
(404) 294-3600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10982
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00581215A
—
GA
Enumeration date
01/18/2007
Last updated
09/17/2008
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