Unknown Individual – Periodontics, NPI 1912025784
Periodontics
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
105 CARNEGIE PL
SUITE 113
FAYETTEVILLE, GA 302143980
Phone: (678) 817-0600
Fax: (678) 817-0601
Type: Mailing
2844 LAKE PARK DR
JONESBORO, GA 302364133
Phone: (770) 478-8459
Fax: (770) 478-6026
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30214)
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