Provider Demographics
NPI:1659668994
Name:THE ART OF COSMETIC DENTISTRY, PC
Entity Type:Organization
Organization Name:THE ART OF COSMETIC DENTISTRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-591-7894
Mailing Address - Street 1:3333 PIEDMONT RD NE
Mailing Address - Street 2:TERMINUS 200, STE 130
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1712
Mailing Address - Country:US
Mailing Address - Phone:404-846-6797
Mailing Address - Fax:
Practice Address - Street 1:3333 PIEDMONT RD NE
Practice Address - Street 2:TERMINUS 200, STE 130
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1712
Practice Address - Country:US
Practice Address - Phone:404-846-6797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty