Organization
SRR LLC
Active
Other names
Simple Smiles Restorative And Cosmetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HIRAL ANKUR PATEL RDH (OWNER/MANAGER)
(706) 346-9516
Entity
Organization
Contact information
Practice address
114 MIRRAMONT LAKE DR, WOODSTOCK, GA 30189-8213
(770) 592-7000
(770) 517-7403
Mailing address
114 MIRRAMONT LAKE DR, WOODSTOCK, GA 30189-8213
(770) 592-7000
(770) 517-7403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
LC20140000214
GA
Other
Enumeration date
03/20/2014
Last updated
03/21/2014
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