Provider Demographics
NPI:1881761849
Name:KING, PAUL WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WILLIAM
Last Name:KING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 CIRCLE 75 PKWY
Mailing Address - Street 2:SUITE 20
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6079
Mailing Address - Country:US
Mailing Address - Phone:770-952-1777
Mailing Address - Fax:770-952-1779
Practice Address - Street 1:1000 CIRCLE 75 PKWY
Practice Address - Street 2:SUITE 20
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6079
Practice Address - Country:US
Practice Address - Phone:770-952-1777
Practice Address - Fax:770-952-1779
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN007445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist