Provider Demographics
NPI:1881373892
Name:DENTFIRST, P.C.
Entity type:Organization
Organization Name:DENTFIRST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAJUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-446-8000
Mailing Address - Street 1:1650 OAKBROOK DR STE 440
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1817
Mailing Address - Country:US
Mailing Address - Phone:770-446-8000
Mailing Address - Fax:678-701-3294
Practice Address - Street 1:680 MARKET PLACE BLVD.,
Practice Address - Street 2:SUITE A
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248
Practice Address - Country:US
Practice Address - Phone:770-446-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty