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Organization

INTERNATIONAL FAMILY DENTAL CENTER P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES WILKINS SR. (ADMINISTRATOR)
(770) 368-9159
Entity
Organization

Contact information

Practice address
5495 JIMMY CARTER BLVD STE A14, NORCROSS, GA 30093-1518
(770) 368-9159
(770) 368-9119
Mailing address
5495 JIMMY CARTER BLVD STE A14, NORCROSS, GA 30093-1518
(770) 368-9159
(770) 368-9119

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11792
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00770316E
GA
Enumeration date
04/22/2008
Last updated
04/22/2008
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