Provider Demographics
NPI:1447396957
Name:GUILLAUME, DIDIER (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIDIER
Middle Name:
Last Name:GUILLAUME
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190856
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31119-0856
Mailing Address - Country:US
Mailing Address - Phone:404-816-7848
Mailing Address - Fax:770-441-0299
Practice Address - Street 1:2233 PEACHTREE RD. NE
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-609-6898
Practice Address - Fax:404-609-6894
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0126731223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics