Provider Demographics
NPI:1083736987
Name:RIFKIN, SUSAN GOLDBERG (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:GOLDBERG
Last Name:RIFKIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:988 FOREST POND CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-4416
Mailing Address - Country:US
Mailing Address - Phone:770-552-7057
Mailing Address - Fax:
Practice Address - Street 1:1000 ABERNATHY RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5606
Practice Address - Country:US
Practice Address - Phone:770-393-0800
Practice Address - Fax:770-393-9570
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA97301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice