Provider Demographics
NPI:1548339575
Name:BEST CARE DENTAL INC.
Entity type:Organization
Organization Name:BEST CARE DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-463-0063
Mailing Address - Street 1:3700 MARKET ST STE A2
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30021-2652
Mailing Address - Country:US
Mailing Address - Phone:404-298-3258
Mailing Address - Fax:404-298-7543
Practice Address - Street 1:3700 MARKET ST STE A2
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-2652
Practice Address - Country:US
Practice Address - Phone:404-298-3258
Practice Address - Fax:404-298-7543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0117981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00805538AMedicaid
GA00805538CMedicaid
GA00805538DMedicaid
GA00805538BMedicaid