Provider Demographics
NPI:1609085620
Name:JOHN H EATON D.D.S., P.C.
Entity Type:Organization
Organization Name:JOHN H EATON D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-457-6558
Mailing Address - Street 1:1776 OLD SPRING HOUSE LN
Mailing Address - Street 2:SUITE 301
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6225
Mailing Address - Country:US
Mailing Address - Phone:770-457-6558
Mailing Address - Fax:770-457-6683
Practice Address - Street 1:1776 OLD SPRING HOUSE LN
Practice Address - Street 2:SUITE 301
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6225
Practice Address - Country:US
Practice Address - Phone:770-457-6558
Practice Address - Fax:770-457-6683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0097231223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty