Provider Demographics
NPI:1215005376
Name:CHILDREN'S DENTAL CENTER, PC
Entity Type:Organization
Organization Name:CHILDREN'S DENTAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-382-3536
Mailing Address - Street 1:16 FELTON PL # B
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-2152
Mailing Address - Country:US
Mailing Address - Phone:770-382-3536
Mailing Address - Fax:770-382-1915
Practice Address - Street 1:16 FELTON PL # B
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-2152
Practice Address - Country:US
Practice Address - Phone:770-382-3536
Practice Address - Fax:770-382-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty