Organization
SMDENTALPC
Active
Other names
East Atlanta Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHERVIN MESHKIAN DDS (DENTIST/CEO)
(404) 688-2223
Entity
Organization
Contact information
Practice address
440 FLAT SHOALS AVE SE, ATLANTA, GA 30316-1915
(404) 688-2223
(404) 688-6602
Mailing address
440 FLAT SHOALS AVE SE, ATLANTA, GA 30316-1915
(404) 688-2223
(404) 688-6602
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
DN012987
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147751B
—
GA
Enumeration date
12/18/2014
Last updated
12/18/2014
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