Provider Demographics
NPI:1770752990
Name:ENOCH, HAROLD OWEN (DMD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:OWEN
Last Name:ENOCH
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 1:2155 POST OAK TRITT RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8620
Mailing Address - Country:US
Mailing Address - Phone:770-977-0377
Mailing Address - Fax:770-578-8142
Practice Address - Street 1:2155 POST OAK TRITT RD
Practice Address - Street 2:SUITE 180
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8620
Practice Address - Country:US
Practice Address - Phone:770-977-0377
Practice Address - Fax:770-578-8142
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0096761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics