Provider Demographics
NPI:1609918747
Name:CASON, LENNARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:LENNARD
Middle Name:
Last Name:CASON
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 1:1871 WASHINGTON AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-4128
Mailing Address - Country:US
Mailing Address - Phone:404-761-7297
Mailing Address - Fax:404-768-1813
Practice Address - Street 1:1871 WASHINGTON AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-4128
Practice Address - Country:US
Practice Address - Phone:404-761-7297
Practice Address - Fax:404-768-1813
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0110791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice