Provider Demographics
NPI:1770890212
Name:JOE F. HAIR, JR., D.M.D., P.A.
Entity type:Organization
Organization Name:JOE F. HAIR, JR., D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAIR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:770-949-1005
Mailing Address - Street 1:6842 DOUGLAS BLVD
Mailing Address - Street 2:SUITE K
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1576
Mailing Address - Country:US
Mailing Address - Phone:770-949-1005
Mailing Address - Fax:
Practice Address - Street 1:6842 DOUGLAS BLVD
Practice Address - Street 2:SUITE K
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1576
Practice Address - Country:US
Practice Address - Phone:770-949-1005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0096361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty