Provider Demographics
NPI:1619537008
Name:BARTHOLOMEW, ALEX H (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:H
Last Name:BARTHOLOMEW
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 1:350 COUNTRY CLUB DR STE E
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9084
Mailing Address - Country:US
Mailing Address - Phone:770-507-7435
Mailing Address - Fax:770-507-6423
Practice Address - Street 1:350 COUNTRY CLUB DR STE E
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9084
Practice Address - Country:US
Practice Address - Phone:770-507-7435
Practice Address - Fax:770-507-6423
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0158691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice