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General NPI Number Information
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NPI Number | 1073067591
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Entity Type | Organization
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Legal Business Name | TITANIUM DENTAL
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 08/12/2016
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Provider Practice Location Address
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Address Line | 3796 SATELLITE BLVD STE 101
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City | DULUTH
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State | GA
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Zip | 30096-5698
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Country | US
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Telephone | 888-414-6752
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Fax | 888-414-6752
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Provider Business Mailing Address
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Address Line | 3796 SATELLITE BLVD STE 101
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City | DULUTH
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State | GA
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Zip | 30096-5698
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Country | US
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Telephone | 888-414-6752
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Fax | 888-414-6752
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES CHUNG YOON
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Credential | DMD, MS
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Telephone | 706-399-7266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN015124
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License Number State | GA
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