Organization
PEDOZONE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL DEANN SMITH (TREATMENT COORDINATOR)
(770) 974-3633
Entity
Organization
Contact information
Practice address
8879 DALLAS ACWORTH HWY, DALLAS, GA 30132-7905
(770) 974-3633
(770) 974-3660
Mailing address
3104 CREEKSIDE VILLAGE DR NW STE 401, KENNESAW, GA 30144-2393
(770) 974-3633
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DNO14556
GA
Other
Enumeration date
10/19/2017
Last updated
03/17/2018
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