Provider Demographics
NPI:1770637514
Name:BAAWO, ALBERT S JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:S
Last Name:BAAWO
Suffix:JR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:3280 HOWELL MILL RD NW
Mailing Address - Street 2:STE 315
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4111
Mailing Address - Country:US
Mailing Address - Phone:404-355-6088
Mailing Address - Fax:404-355-6086
Practice Address - Street 1:3280 HOWELL MILL RD NW
Practice Address - Street 2:STE 315
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4111
Practice Address - Country:US
Practice Address - Phone:404-355-6088
Practice Address - Fax:404-355-6086
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GADN0128071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice