James A Granade III D.M.D

NPI 1689799819 - Dentist - 122300000X

NPI Details
NPI 1689799819
Gender Male
Enumeration Date 03/20/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
4879 LAVISTA RD
SUITE 100
TUCKER GA, 30084-8517, US
Phone (770) 491-3888
Fax
Business Location
4879 LAVISTA RD
SUITE 100
TUCKER GA, 30084-8517, US
Phone
Fax
Toxanomy
Taxonomy Code 122300000X
License State Georgia
License Number DN011412
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According to our database, Dr. James A Granade III D.M.D NPI is 1689799819, taxonomy code is 122300000X and license number is DN011412, license state is located at Georgia. James A Granade III D.M.D physically located at 4879 Lavista Rd, Tucker GA, 30084-8517. NPI Number James A Granade III D.M.D has the Individual type.

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1689799819 NPI number is provided on an as is basis without warranty of any kind. 1689799819 is maintained by the National Plan & Provider Enumeration System. The contents of James A Granade III D.M.D are for informational purposes only.