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Organization

RADIANT SMILES DENTAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE WU DDS (MANAGING PARTNER)
(404) 389-0700
Entity
Organization

Contact information

Practice address
587 VIRGINIA AVE NE STE 5, ATLANTA, GA 30306-3688
(404) 389-0700
Mailing address
587 VIRGINIA AVE NE STE 5, ATLANTA, GA 30306-3688

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
12/13/2011
Last updated
12/13/2011
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