Provider Demographics
NPI:1043347891
Name:ABNEY, CHARLES L (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:ABNEY
Suffix:
Gender:M
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 N WILLIAMSBURG DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3500
Mailing Address - Country:US
Mailing Address - Phone:404-321-4588
Mailing Address - Fax:404-321-1892
Practice Address - Street 1:1991 N WILLIAMSBURG DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3500
Practice Address - Country:US
Practice Address - Phone:404-321-4588
Practice Address - Fax:404-321-1892
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA58-11549761223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics