Organization
RSS MICHAEL DIERKES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DIERKES (OWNER)
(817) 405-7470
Entity
Organization
Contact information
Practice address
4920 ROSWELL RD STE 255, ATLANTA, GA 30342-2686
(844) 859-2525
Mailing address
1050 TEXAN TRL STE 300, GRAPEVINE, TX 76051-3759
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN009675
GA
Other
Enumeration date
01/09/2018
Last updated
01/27/2019
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