Provider Demographics
NPI:1275047904
Name:DANIEL A KING DDS, PC
Entity Type:Organization
Organization Name:DANIEL A KING DDS, PC
Other - Org Name:CHILDREN'S DENTAL ZONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-756-7035
Mailing Address - Street 1:3455 OLD ALABAMA RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5526
Mailing Address - Country:US
Mailing Address - Phone:770-777-1222
Mailing Address - Fax:678-336-1597
Practice Address - Street 1:3455 OLD ALABAMA RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-5526
Practice Address - Country:US
Practice Address - Phone:770-777-1222
Practice Address - Fax:678-336-1597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0129191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty