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Organization

IMAGIX FAMILY DENTISTRY OF VININGS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRYSTAL CHOUINARD (CREDENTIALING SPECIALIST)
(941) 955-3150
Entity
Organization

Contact information

Practice address
2460 CUMBERLAND PKWY SE, 210, ATLANTA, GA 30339-4519
(770) 433-2414
Mailing address
2460 CUMBERLAND PKWY SE, 210, ATLANTA, GA 30339-4519
(770) 433-2414

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
GA

Other

Enumeration date
11/17/2015
Last updated
11/17/2015
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