MEDICARE: DR. WILLIAM BRIAN HAWKINS D.D.S.,M.A.G.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9434	GA

General Provider Information

NPI Number	:	1043378342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM BRIAN HAWKINS D.D.S.,M.A.G.D.

Provider Business Mailing Address
First Line	:	3535 ROSWELL RD STE 56
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8828
Country	:	US
Telephone Number	:	770-977-5647
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ROSWELL RD STE 56
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8828
Country	:	US
Telephone Number	:	770-977-5647
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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