Mableton Dental INC

NPI #1164634440 in Mableton, Georgia

Provider Information

NPI Number: 1164634440
Entity Type: Organization
Organization Name: Mableton Dental INC
Primary Specialty: Dentist
Enumeration Date: May 7, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 5841 MABLETON PKWY
City: Mableton
State: Georgia
ZIP Code: 30126
Phone: (770) 944-8700

Authorized Official

Name: DR. ROLLIN B. JACKSON JR., DDS
Title: DENTIST, OWNER
Phone: (770) 944-8700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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