Provider Demographics
NPI:1619378122
Name:BUCHANAN, ZERITA CHRISTINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZERITA
Middle Name:CHRISTINE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4254 SANDSTONE SHORES DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3952
Mailing Address - Country:US
Mailing Address - Phone:404-289-7311
Mailing Address - Fax:
Practice Address - Street 1:2998 TURNER HILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6997
Practice Address - Country:US
Practice Address - Phone:404-289-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0148751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice