Individual
DR. BOBBY TERON PITTMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4458 JONESBORO RD, FOREST PARK, GA 30297-4314
(678) 904-5665
Mailing address
2788 BAYARD ST, EAST POINT, GA 30344-3441
(770) 407-8700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013164
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
652095315F
—
GA
Enumeration date
11/29/2006
Last updated
06/18/2014
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