Provider Demographics
NPI:1417084641
Name:BANG-CROOKS, ERIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:
Last Name:BANG-CROOKS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:BANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 80097
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30366-0097
Mailing Address - Country:US
Mailing Address - Phone:770-619-2909
Mailing Address - Fax:770-619-2939
Practice Address - Street 1:11775 NORTHFALL LN
Practice Address - Street 2:SUITE 107
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-7978
Practice Address - Country:US
Practice Address - Phone:770-619-2909
Practice Address - Fax:770-619-2939
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN011829122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist