Provider Demographics
NPI:1043378342
Name:HAWKINS, WILLIAM BRIAN (DDS,MAGD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRIAN
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DDS,MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 ROSWELL RD STE 56
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8828
Mailing Address - Country:US
Mailing Address - Phone:770-977-5647
Mailing Address - Fax:
Practice Address - Street 1:3535 ROSWELL RD STE 56
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8828
Practice Address - Country:US
Practice Address - Phone:770-977-5647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice