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General NPI Number Information
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NPI Number | 1396311718
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Entity Type | Individual
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Provider Name | GARRETT CHARETTE DMD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 3700 CRESTWOOD PKWY NW STE 180
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City | DULUTH
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State | GA
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Zip | 30096-5583
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Country | US
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Telephone | 413-313-6683
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 AZALEA GARDEN DR
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City | DUNWOODY
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State | GA
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Zip | 30338-7917
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Country | US
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Telephone | 413-313-6683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN1859184
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN122807
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN122807
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License Number State | GA
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