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Organization

COLEMAN DENTAL ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARLA O. COLEMAN DDS (PRESIDENT)
(404) 523-3153
Entity
Organization

Contact information

Practice address
970 MARTIN LUTHER KING JR DR SW, SUITE 301, ATLANTA, GA 30314-2962
(404) 523-3153
(404) 523-0136
Mailing address
970 MARTIN LUTHER KING JR DR SW, SUITE 301, ATLANTA, GA 30314-2962
(404) 523-3153
(404) 523-0136

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN010307
GA
1223P0221X
Pediatric Dentistry
DN013127
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000364823A
GA
05
692906293A
GA
Enumeration date
11/06/2008
Last updated
11/06/2008
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