Provider Demographics
NPI:1568473924
Name:ORTHODONTIC ASSOCIATES PC
Entity Type:Organization
Organization Name:ORTHODONTIC ASSOCIATES PC
Other - Org Name:DR WILLIAM W MOTLEY DDS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOTLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-483-5260
Mailing Address - Street 1:1455 KLONDIKE RD
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2462
Mailing Address - Country:US
Mailing Address - Phone:770-483-5260
Mailing Address - Fax:770-483-0576
Practice Address - Street 1:1455 KLONDIKE RD
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2462
Practice Address - Country:US
Practice Address - Phone:770-483-5260
Practice Address - Fax:770-483-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty