Individual
ANTHONY JOHN DIDATO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3625 BRASELTON HWY, 101, DACULA, GA 30019-1014
(706) 993-6488
Mailing address
3072 DALE DR NE, ATLANTA, GA 30305-2776
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
014280
GA
Other
Enumeration date
04/25/2011
Last updated
07/13/2016
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