Organization · Type 2 NPI

Smile 23 Georgia LLC

Periodontics · Atlanta, GA

NPI number 1457019515 Active

Practice location

3280 Howell Mill Rd NW Ste 331
Atlanta, GA 30327-4109

Specialties and licenses

Taxonomy	Code	License
Periodontics Primary	1223P0300X	None listed

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

3 other providers at this address

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NPI record

NPI: 1457019515
Entity type: Organization (Type 2)
Issued: Dec 6, 2021
Last updated: Dec 6, 2021
Status: Active

Other names

Buckhead Periodontics · doing business as
Buckhead Specialty Group · doing business as
Buckhead Periodontics P.c. · former legal business name

Authorized official

Trevor Bryan Tune
Cdo
(636) 233-1882

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1457019515

Smile 23 Georgia LLC's National Provider Identifier is 1457019515, issued on Dec 6, 2021. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Atlanta, GA. The record was last updated on Dec 6, 2021.