Provider Demographics
NPI:1720103120
Name:STARLING, ALVA LUTRELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALVA
Middle Name:LUTRELL
Last Name:STARLING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5992 COVINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3705
Mailing Address - Country:US
Mailing Address - Phone:770-322-3121
Mailing Address - Fax:770-322-5485
Practice Address - Street 1:5992 COVINGTON HWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3705
Practice Address - Country:US
Practice Address - Phone:770-322-3121
Practice Address - Fax:770-322-5485
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0127191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice