Provider Demographics
NPI:1346322708
Name:LOTTIER, SHAWN P (DDS, PC)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:P
Last Name:LOTTIER
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 PEACHTREE RD NE
Mailing Address - Street 2:#1125
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326
Mailing Address - Country:US
Mailing Address - Phone:404-365-0211
Mailing Address - Fax:404-420-2642
Practice Address - Street 1:3400 PEACHTREE RD NE
Practice Address - Street 2:SUITE 1125
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326
Practice Address - Country:US
Practice Address - Phone:404-365-0211
Practice Address - Fax:404-420-2642
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA124701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice