NPI 1205211133

Fabulous Smiles of Lilburn

Organisation Point of Service Lilburn, GA

Practice location

Address: 331 Arcado Rd NW, Lilburn, GA 30047-3077
Phone: (770) 557-0788
Fax: (404) 420-2951

Authorised official

Name: Nikki Rolls
Title: Office Manager
Phone: (770) 557-0788

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence DN011973 (GA)

Other Point of Service providers in Georgia →

Registry record

NPI: 1205211133
Entity type: Organization
NPI issued: 21 Jul 2015
Record last updated: 21 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.