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General NPI Number Information
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NPI Number | 1902097579
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Entity Type | Individual
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Provider Name | ZAIN ODEH DABBAS D.D.S
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Gender | Female
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/16/2012
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Provider Practice Location Address
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Address Line | 2594 LOGANVIILE HWY, # 102
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City | GRAYSON
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State | GA
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Zip | 30017
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Country | US
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Telephone | 678-672-1590
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 ALBEMARLE WAY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30017
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Country | US
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Telephone | 678-779-5851
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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 | DN013618
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License Number State | GA
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