Paul Ivey Nettles Llc

NPI 1063564078 - Dentist - 1223G0001X

NPI Details
NPI 1063564078
Enumeration Date 01/18/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name PAUL I PAUL
Position PRESIDENT
Phone (770) 997-9090
Fax
Practice Location
1177 GARDEN WALK BLVD
COLLEGE PARK GA, 30349-6245, US
Phone (770) 997-9090
Fax
Business Location
730 HIGHMEADE TER
ALPHARETTA GA, 30005-3755, US
Phone (770) 337-0976
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Georgia
License Number 11589
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According to our database, Paul Ivey Nettles Llc NPI is 1063564078, taxonomy code is 1223G0001X and license number is 11589, license state is located at Georgia. Paul Ivey Nettles Llc physically located at 1177 Garden Walk Blvd, College Park GA, 30349-6245. NPI Number 1033115704 has the healthcare provider type.

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1063564078 NPI number is provided on an as is basis without warranty of any kind. 1063564078 is maintained by the National Plan & Provider Enumeration System. The contents of Paul Ivey Nettles Llc are for informational purposes only.