Healthcare Provider Details

I. General information

NPI: 1497978191
Provider Name (Legal Business Name): GABOR HEGEDUS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 POWERS FERRY RD NW STE-116
ATLANTA GA
30339-2907
US

IV. Provider business mailing address

6400 POWERS FERRY RD NW STE-116
ATLANTA GA
30339-2907
US

V. Phone/Fax

Practice location:
  • Phone: 770-955-1684
  • Fax:
Mailing address:
  • Phone: 770-955-1684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9937
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: