Organization
FAMILY DENTISTRY OF MARIETTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN V GORDON (BUSINESS MANAGER)
(770) 977-9090
Entity
Organization
Contact information
Practice address
2125 POST OAK TRITT RD, MARIETTA, GA 30062-1609
(770) 977-9090
Mailing address
2125 POST OAK TRITT RD, MARIETTA, GA 30062-1609
(770) 977-9090
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012338
GA
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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