Organization
CRABAPPLE ORTHO AND PEDO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER SNOW (CREDENTIALING COORDINATOR)
(404) 410-1340
Entity
Organization
Contact information
Practice address
12385 CRABAPPLE RD STE 100, ALPHARETTA, GA 30004-6357
(770) 901-2369
Mailing address
12385 CRABAPPLE RD STE 100, ALPHARETTA, GA 30004-6357
(770) 901-2369
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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