Provider Demographics
NPI:1073979837
Name:H&B FAMILY DENTAL, LLC
Entity Type:Organization
Organization Name:H&B FAMILY DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMEBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-623-1198
Mailing Address - Street 1:10360 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5927
Mailing Address - Country:US
Mailing Address - Phone:770-623-1198
Mailing Address - Fax:
Practice Address - Street 1:10360 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-5927
Practice Address - Country:US
Practice Address - Phone:770-623-1198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-10
Last Update Date:2016-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0102081223G0001X
GADN0151111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty