Organization
SUPERIOR DENTAL OF EAST COBB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOBBY T SHIRLEY DMD (OWNER)
(678) 977-8119
Entity
Organization
Contact information
Practice address
2745 SANDY PLAINS RD STE 118, MARIETTA, GA 30066-4327
(770) 977-1611
Mailing address
347 LIGHTBURN CRK NW, MARIETTA, GA 30064-1307
(678) 977-8119
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012980
GA
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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