Organization
JOSE L. FAJARDO, D.M.D,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE LUIS FAJARDO D.M.D (DENTIST)
(770) 368-1818
Entity
Organization
Contact information
Practice address
5720 BUFORD HWY, SUITE 101, NORCROSS, GA 30071-2577
(770) 368-1818
(770) 368-1618
Mailing address
5720 BUFORD HWY, SUITE 101, NORCROSS, GA 30071-2577
(770) 368-1818
(770) 368-1618
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
011347
GA
Other
Enumeration date
05/14/2007
Last updated
10/03/2014
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