Provider Demographics
NPI:1497007991
Name:FEATHER TOUCH DENTAL CARE LLC
Entity type:Organization
Organization Name:FEATHER TOUCH DENTAL CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-879-6634
Mailing Address - Street 1:1175 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1204
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30361-3528
Mailing Address - Country:US
Mailing Address - Phone:404-892-2097
Mailing Address - Fax:866-318-6029
Practice Address - Street 1:1175 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1204
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30361-3528
Practice Address - Country:US
Practice Address - Phone:404-892-2097
Practice Address - Fax:866-318-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0139031223G0001X
GA70991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty