Provider Demographics
NPI:1245267749
Name:ADLER, JOEL MARTIN (DDS)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:MARTIN
Last Name:ADLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:JOEL M. ADLER, DDS
Mailing Address - Street 2:2677 RIDGE VALLEY RD NW
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:404-351-7159
Mailing Address - Fax:404-351-7248
Practice Address - Street 1:JOEL M. ADLER, DDS
Practice Address - Street 2:2677 RIDGE VALLEY RD NW
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:404-351-7159
Practice Address - Fax:404-351-7248
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0063911223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00044096AMedicaid
GAT-86427Medicare UPIN
GA70019219DAMedicare ID - Type Unspecified