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General NPI Number Information
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NPI Number | 1841603222
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Entity Type | Individual
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Provider Name | JOVAS C. BOOKER D.M.D
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Gender | Male
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 16 FELTON PL UNIT B
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2182
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Country | US
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Telephone | 770-382-3536
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Fax |
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Provider Business Mailing Address
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Address Line | 16 FELTON PL UNIT B
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City | CARTERSVILLE
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State | GA
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Zip | 30120-2182
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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 |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN014798
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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 | D2040438
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN014798
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License Number State | GA
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