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General NPI Number Information
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NPI Number | 1649306234
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Entity Type | Individual
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Provider Name | ARTHUR D BODNER DMD
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 2339 PEACHTREE RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-4147
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Country | US
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Telephone | 404-233-1547
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Fax | 404-233-0991
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Provider Business Mailing Address
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Address Line | 3525 PIEDMONT RD NE STE 420
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City | ATLANTA
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State | GA
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Zip | 30305-1578
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Country | US
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Telephone | 404-261-3091
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Fax | 404-261-0048
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN007135
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License Number State | GA
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