Specialty Providers at Children's, LLC
NPI #1346606076 in Brookhaven, Georgia
Provider Information
- NPI Number
- 1346606076
- Entity Type
- Organization
- Organization Name
- Specialty Providers at Children's, LLC
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Jan 11, 2016
- Last Updated
- Oct 17, 2025
Practice Location
- Address
- 1575 NORTHEAST EXPY NE
- City
- Brookhaven
- State
- Georgia
- ZIP Code
- 30329-2401
- Phone
- (404) 785-7876
Authorized Official
- Name
- JOE CAVASIN
- Title
- MANAGER PROVIDER ENROLLMENT
- Phone
- (404) 785-5869
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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