Provider Demographics
NPI:1508968553
Name:SINGLETON, DOUGLAS ALEXANDER (DDS, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:ALEXANDER
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:DDS, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:3104 CREEKSIDE VILLAGE DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2324
Mailing Address - Country:US
Mailing Address - Phone:770-974-3633
Mailing Address - Fax:770-974-3660
Practice Address - Street 1:3104 CREEKSIDE VILLAGE DR NW
Practice Address - Street 2:SUITE 401
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2324
Practice Address - Country:US
Practice Address - Phone:770-974-3633
Practice Address - Fax:770-974-3660
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics