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General NPI Number Information
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NPI Number | 1609085620
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Entity Type | Organization
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Legal Business Name | JOHN H EATON D.D.S., P.C.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 1776 OLD SPRING HOUSE LN SUITE 301
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City | DUNWOODY
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State | GA
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Zip | 30338-6225
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Country | US
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Telephone | 770-457-6558
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Fax | 770-457-6683
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Provider Business Mailing Address
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Address Line | 1776 OLD SPRING HOUSE LN SUITE 301
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City | DUNWOODY
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State | GA
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Zip | 30338-6225
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Country | US
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Telephone | 770-457-6558
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Fax | 770-457-6683
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN H EATON
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Credential | D.D.S.
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Telephone | 770-457-6558
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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 | 009723
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License Number State | GA
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