Decatur Dental Group, LLC

NPI #1891002531 in Decatur, Georgia

Provider Information

NPI Number: 1891002531
Entity Type: Organization
Organization Name: Decatur Dental Group, LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 1, 2010
Last Updated: Sep 21, 2011

Practice Location

Address: 3660 FLAT SHOALS RD
Address 2: SUITE 100
City: Decatur
State: Georgia
ZIP Code: 30034-1632
Phone: (404) 243-0217

Authorized Official

Name: RESA JOHNELLE ROBERTS
Title: ORGANIZER
Phone: (404) 556-1393

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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