Executive Park Dentistry, P.c.

NPI #1124373139 in Atlanta, Georgia

Provider Information

NPI Number: 1124373139
Entity Type: Organization
Organization Name: Executive Park Dentistry, P.c.
Primary Specialty: Dentist
Enumeration Date: Jul 16, 2012
Last Updated: Jul 16, 2012

Practice Location

Address: 17 EXECUTIVE PARK DR NE
Address 2: SUITE 100
City: Atlanta
State: Georgia
ZIP Code: 30329-2251
Phone: (404) 633-0715

Authorized Official

Name: DR. OMAR S DAMJI
Title: OWNER/DENTIST
Phone: (404) 664-6876

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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