Provider Demographics
NPI:1649601089
Name:EAST POINT FAMILY DENTAL CENTER PC
Entity type:Organization
Organization Name:EAST POINT FAMILY DENTAL CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOI
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMONT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:404-761-1659
Mailing Address - Street 1:606 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:606 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1918
Practice Address - Country:US
Practice Address - Phone:404-761-1659
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty