MEDICARE: DR. JAMES PRIZANT SYLVAN D.D.S.

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	8454	GA

General Provider Information

NPI Number	:	1831253905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES PRIZANT SYLVAN D.D.S.

Provider Business Mailing Address
First Line	:	3901 ROSWELL RD
Second Line	:	SUITE # 220
City	:	MARIETTA
State	:	GA
Zip	:	30062-8809
Country	:	US
Telephone Number	:	770-977-0977
Fax Number	:	770-977-2910

Provider Business Practice Location Address
First Line	:	3901 ROSWELL RD
Second Line	:	SUITE # 220
City	:	MARIETTA
State	:	GA
Zip	:	30062-8809
Country	:	US
Telephone Number	:	770-977-0977
Fax Number	:	770-977-2910

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	06/16/2009

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