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General NPI Number Information
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NPI Number | 1386762037
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Entity Type | Organization
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Legal Business Name | JAMES PROCTOR DDS PC
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2045 HONEY CREEK PKWY SE
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City | CONYERS
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State | GA
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Zip | 30013-2975
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Country | US
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Telephone | 770-483-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 HONEY CREEK PKWY SE
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City | CONYERS
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State | GA
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Zip | 30013-2975
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Country | US
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Telephone | 770-483-6800
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES MICHAEL PROCTOR
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Credential | DDS
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Telephone | 770-483-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1164
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License Number State | GA
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