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General NPI Number Information
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NPI Number | 1174870430
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Entity Type | Organization
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Legal Business Name | WEST ATLANTA ENDODONTICS
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Dates
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Enumeration Date | 08/06/2012
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 1790 MULKEY RD SUITE 2
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City | AUSTELL
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State | GA
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Zip | 30106-1122
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Country | US
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Telephone | 770-944-8822
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Fax | 770-944-0459
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Provider Business Mailing Address
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Address Line | 1790 MULKEY RD SUITE 2
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City | AUSTELL
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State | GA
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Zip | 30106-1122
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Country | US
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Telephone | 770-944-8822
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Fax | 770-944-0459
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Authorized Official
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Title or Position | DENTIST/CEO
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Name | DR. DAVID NORRINGTON
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Credential | DMD
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Telephone | 770-944-8822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 8842
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN013597
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License Number State | GA
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