Organization
DENTAL EXCELLENCE OF KENNESAW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DERRICK SMITH D.D.S. (PRESIDENT)
(770) 429-0955
Entity
Organization
Contact information
Practice address
2750 WATTS DR NW, KENNESAW, GA 30144-2721
(770) 429-0955
(770) 429-0219
Mailing address
2750 WATTS DR NW, KENNESAW, GA 30144-2721
(770) 429-0955
(770) 429-0219
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN009592
GA
Other
Enumeration date
12/13/2006
Last updated
08/22/2020
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