OrganizationActive
Fabulous Smiles of Atlanta LLC
NPI 1962660555 · Preferred Provider Organization · Atlanta, GA
Provider details
- NPI number
- 1962660555
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Danielle Greene, President(404) 758-0770
- License
- 011973 (GA)
Specialties & taxonomies
Managed Care Organizations
Practice location
1188 Ralph David Abernathy Blvd Sw
Suite 101
Atlanta, GA 30310-1754
Phone: (404) 758-0770
Approximate (ZIP-level) locationGet directions
Mailing address
1188 Ralph David Abernathy Blvd Sw
Atlanta, GA 30310-1754
Registry dates
- Enumerated
- 2008-05-30
- Last updated
- 2008-05-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.