MEDICARE: MAGDY ATTIA D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN012425	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245284041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGDY ATTIA D.M.D.

Provider Business Mailing Address
First Line	:	720 WEST LANIER AVENUE
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214
Country	:	US
Telephone Number	:	770-461-7700
Fax Number	:	770-461-7750

Provider Business Practice Location Address
First Line	:	30 WARREN ST
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30317
Country	:	US
Telephone Number	:	404-370-7360
Fax Number	:	404-370-7379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	05/21/2013

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Directions to “ MAGDY ATTIA D.M.D.” Practice Location

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