Healthcare Provider Details

I. General information

NPI: 1174434039
Provider Name (Legal Business Name): JANELLE FABICO DULIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4226 HARTLEY BRIDGE RD STE 102
MACON GA
31216-4116
US

IV. Provider business mailing address

4226 HARTLEY BRIDGE RD STE 102
MACON GA
31216-4116
US

V. Phone/Fax

Practice location:
  • Phone: 478-621-7657
  • Fax:
Mailing address:
  • Phone: 478-621-7657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN124355
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: