Provider Demographics
NPI:1740542679
Name:PALADINES, JORGE ALEJANDRO (DMD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ALEJANDRO
Last Name:PALADINES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 WEXFORD CT
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-2494
Mailing Address - Country:US
Mailing Address - Phone:678-499-0819
Mailing Address - Fax:
Practice Address - Street 1:4574 LAWRENCEVILLE HWY NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3618
Practice Address - Country:US
Practice Address - Phone:770-921-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0144071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice