Provider Demographics
NPI:1205991056
Name:HESSLER, DALLAS DAN VON (DO)
Entity type:Individual
Prefix:DR
First Name:DALLAS
Middle Name:DAN VON
Last Name:HESSLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 ARGONNE AVE NE # A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1613
Mailing Address - Country:US
Mailing Address - Phone:404-872-3797
Mailing Address - Fax:404-872-3798
Practice Address - Street 1:849 ARGONNE AVE NE # A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1613
Practice Address - Country:US
Practice Address - Phone:404-872-3797
Practice Address - Fax:404-872-3798
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2023-06-20
Deactivation Date:2023-06-14
Deactivation Code:
Reactivation Date:2023-06-19
Provider Licenses
StateLicense IDTaxonomies
GA046545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine