Provider Demographics
NPI:1710015789
Name:MCDEVITT, MICHAEL J (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MCDEVITT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:3580 PIEDMONT RD NE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1506
Mailing Address - Country:US
Mailing Address - Phone:404-231-1080
Mailing Address - Fax:404-231-8719
Practice Address - Street 1:3580 PIEDMONT RD NE
Practice Address - Street 2:SUITE 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1506
Practice Address - Country:US
Practice Address - Phone:404-231-1080
Practice Address - Fax:404-231-8719
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA77621223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics