Bella Dental Services, P.C
Organization Active NPI Dentist · Clarkston, GA
NPI 1407152259 · NPPES record last updated Jan 26, 2011
Key facts
- NPI
- 1407152259
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- DNO13198 (GA)
- Legal business name
- BELLA DENTAL SERVICES, P.C
- Practice address
- 4122 E Ponce de Leon Ave
Suite #5
Clarkston, GA 30021-1838 - Phone
- (404) 294-8385
- NPI assigned
- Jan 26, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Roderick Sampson Cooper, D.D.S.
- Title
- Owner/Dentist
- Phone
- (404) 294-8385
National Provider Directory
Locations
4122 E Ponce de Leon Ave
Ste 5
Clarkston, GA 30021
Phone (404) 294-8385
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | DNO13198 | GA | Yes |
Addresses
Primary practice location
4122 E Ponce de Leon Ave
Suite #5
Clarkston, GA 30021-1838
Mailing address
4122 E Ponce de Leon Ave
Suite #5
Clarkston, GA 30021
Phone (404) 294-8385
Other providers in Clarkston, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.