Individual
DR. PHILIP JEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1756 CANDLER RD, DECATUR, GA 30032-3277
(678) 904-4252
Mailing address
1432 PACES COMMONS DR, DULUTH, GA 30096-1725
(678) 557-0500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012865
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250276271C
—
GA
05
—
250276271H
—
GA
Enumeration date
10/27/2006
Last updated
08/05/2016
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