Individual
DR. JUSTIN T ECHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1678 MULKEY RD STE D, AUSTELL, GA 30106-1147
(770) 692-1000
Mailing address
509 LINDBERGH PL NE APT 722, ATLANTA, GA 30324-3343
(404) 996-7638
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN014237
GA
1223P0221X
Pediatric Dentistry
Primary
DN014237
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003116346E
—
GA
Enumeration date
06/12/2009
Last updated
09/18/2020
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