| Pda Specialty Of Georgia, Llc | |
|
3466 Cobb Pkwy Nw Ste 170 Acworth GA 30101-5768 | |
| (770) 203-1711 | |
| Not Available |
| Full Name | Pda Specialty Of Georgia, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 3466 Cobb Pkwy Nw Ste 170, Acworth, Georgia |
| Authorized Official Name and Position | Annette Marlow (CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 7246982119 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pda Specialty Of Georgia, Llc 11 S Mill St Ste 200 New Castle PA 16101-3680 Ph: () - | Pda Specialty Of Georgia, Llc 3466 Cobb Pkwy Nw Ste 170 Acworth GA 30101-5768 Ph: (770) 203-1711 |
| NPI Number | 1457853210 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 03/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457853210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | (* (Not Available)) | Primary |
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