Provider Demographics
NPI:1982756672
Name:POLICASTRO, GEORGE FRANCIS JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:FRANCIS
Last Name:POLICASTRO
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2853 CANDLER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-1433
Mailing Address - Country:US
Mailing Address - Phone:404-244-1166
Mailing Address - Fax:
Practice Address - Street 1:2853 CANDLER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-1433
Practice Address - Country:US
Practice Address - Phone:404-244-1166
Practice Address - Fax:404-244-1191
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0080741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice