Provider Demographics
NPI:1629299755
Name:FINK, ROYAL EDWARD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROYAL
Middle Name:EDWARD
Last Name:FINK
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6095 ATLANTA HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-5377
Mailing Address - Country:US
Mailing Address - Phone:770-945-7077
Mailing Address - Fax:770-965-8101
Practice Address - Street 1:6095 ATLANTA HWY STE 200
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-5377
Practice Address - Country:US
Practice Address - Phone:770-945-7077
Practice Address - Fax:770-965-8101
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA80171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice