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General NPI Number Information
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NPI Number | 1710256706
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Entity Type | Organization
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Legal Business Name | A PLUS PEDIATRIC DENTISTRY OF ATLANTA
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Dates
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Enumeration Date | 12/20/2011
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Last Update Date | 12/20/2011
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Provider Practice Location Address
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Address Line | 4300 PACES FERRY RD SE SUITE 405
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City | ATLANTA
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State | GA
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Zip | 30339-5703
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Country | US
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Telephone | 678-391-7453
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Fax |
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Provider Business Mailing Address
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Address Line | 4300 PACES FERRY RD SE SUITE 405
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City | ATLANTA
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State | GA
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Zip | 30339-5703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. JAHA HOWARD
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Credential | D.D.S, M.S.
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Telephone | 678-391-7453
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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 | DN013875
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License Number State | GA
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