Provider Demographics
NPI:1053471698
Name:HOVENOU, HELIODORE ANATOLE (DDS)
Entity Type:Individual
Prefix:
First Name:HELIODORE
Middle Name:ANATOLE
Last Name:HOVENOU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4825 SUGARLOAF PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044
Mailing Address - Country:US
Mailing Address - Phone:770-962-4322
Mailing Address - Fax:
Practice Address - Street 1:4825 SUGARLOAF PKWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044
Practice Address - Country:US
Practice Address - Phone:770-962-4322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0122161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice