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General NPI Number Information
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NPI Number | 1427110402
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Entity Type | Organization
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Legal Business Name | HODGES KING & REUDEL HUBER DDS PA
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1000 CIRCLE 75 PKWY SUITE 20
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City | ATLANTA
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State | GA
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Zip | 30339-6079
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Country | US
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Telephone | 770-952-1777
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Fax | 770-952-1779
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Provider Business Mailing Address
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Address Line | 1000 CIRCLE 75 PKWY STE 20
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City | ATLANTA
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State | GA
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Zip | 30339-6079
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Country | US
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Telephone | 770-952-1777
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Fax | 770-952-1779
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. PAUL WILLIAM KING
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Credential | DDS
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Telephone | 770-952-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN007445
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN007477
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN006968
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License Number State | GA
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