Organization
CHILDREN'S DENTAL CENTER, PC
Active
Other names
Children's Dental Center, PC:Sedation and Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER A CLINE (CREDENTIALING SPECIALIST)
(770) 672-7481
Entity
Organization
Contact information
Practice address
1010 N TENNESSEE ST, STE 105, CARTERSVILLE, GA 30120-8525
(770) 672-7481
(770) 382-1915
Mailing address
1010 N TENNESSEE ST, STE 105, CARTERSVILLE, GA 30120-8525
(770) 672-7481
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/25/2015
Last updated
10/09/2023
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