Organization
EAST ATLANTA ENDODONTICS & MICROSURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JELANI T WASHINGTON DDS (OWNER/DENTIST)
(770) 483-1331
Entity
Organization
Contact information
Practice address
976 E FREEWAY DR SE, SUITE A, CONYERS, GA 30094-5965
(770) 483-1331
(770) 483-2092
Mailing address
976 E FREEWAY DR SE, SUITE A, CONYERS, GA 30094-5965
(770) 483-1331
(770) 483-2092
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DN013277
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083698757
NPPES
GA
Enumeration date
06/16/2011
Last updated
06/16/2011
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