Provider Demographics
NPI:1396859831
Name:HARTNETT, JAMES A (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:HARTNETT
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 1:2705 WILDWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4346
Mailing Address - Country:US
Mailing Address - Phone:912-264-0946
Mailing Address - Fax:912-265-5220
Practice Address - Street 1:2705 WILDWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4346
Practice Address - Country:US
Practice Address - Phone:912-264-0946
Practice Address - Fax:912-265-5220
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN011436122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist