Individual
FADY G EBID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3950 COBB PKWY NW, SUITE 402, ACWORTH, GA 30101-9532
(770) 966-9396
(770) 966-8774
Mailing address
6615 HICKORY FLAT HWY, STE 100, CANTON, GA 30115-7237
(770) 872-0548
(770) 872-0548
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012395
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180312557A
—
GA
Enumeration date
08/30/2006
Last updated
12/12/2016
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