Centers for Pediatric Dental Sedation LLC
NPI #1396108056 in College Park, Georgia
Provider Information
- NPI Number
- 1396108056
- Entity Type
- Organization
- Organization Name
- Centers for Pediatric Dental Sedation LLC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Mar 31, 2016
- Last Updated
- Mar 31, 2016
Practice Location
- Address
- 1631 PHOENIX BLVD STE 8
- City
- College Park
- State
- Georgia
- ZIP Code
- 30349-5545
- Phone
- (678) 545-1682
Authorized Official
- Name
- DR. MARCUS QURAN POLK, M.D.
- Title
- ANESTHESIOLOGIST
- Phone
- (404) 403-4567
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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