Provider Demographics
NPI:1710256706
Name:A PLUS PEDIATRIC DENTISTRY OF ATLANTA
Entity Type:Organization
Organization Name:A PLUS PEDIATRIC DENTISTRY OF ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:678-391-7453
Mailing Address - Street 1:4300 PACES FERRY RD SE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4300 PACES FERRY RD SE
Practice Address - Street 2:SUITE 405
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5703
Practice Address - Country:US
Practice Address - Phone:678-391-7453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0138751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty