MEDICARE: DR. ARTHUR H. DOLT III D.D.S.

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	11596	GA

General Provider Information

NPI Number	:	1962582502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR H. DOLT III D.D.S.

Provider Business Mailing Address
First Line	:	2751 BUFORD HWY NE
Second Line	:	SUITE 302
City	:	ATLANTA
State	:	GA
Zip	:	30324-3207
Country	:	US
Telephone Number	:	404-634-1277
Fax Number	:	404-634-1410

Provider Business Practice Location Address
First Line	:	2751 BUFORD HWY NE
Second Line	:	SUITE 302
City	:	ATLANTA
State	:	GA
Zip	:	30324-3207
Country	:	US
Telephone Number	:	404-634-1277
Fax Number	:	404-634-1410

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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