Organization
KERISA HARRIOTT DMD P.C.
Active
Other names
RenewALL Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERISA HARRIOTT DMD (PRESIDENT/ORTHODONTIST)
(770) 696-6762
Entity
Organization
Contact information
Practice address
4500 WEST VILLAGE PL SE SUITE 2011, SMYRNA, GA 30080-9243
(770) 696-6762
Mailing address
4500 WEST VILLAGE PL SE SUITE 2011, SMYRNA, GA 30080-9243
(770) 696-6762
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356607600
INDIVIDUAL NPI
GA
Enumeration date
03/06/2025
Last updated
03/06/2025
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