Individual
DR. YAHAZIEL SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4763 ATLANTA HWY STE 380, LOGANVILLE, GA 30052-6793
(770) 962-9560
Mailing address
PO BOX 952, FOREST PARK, GA 30298-0952
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015206
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN015206
GA
Other
Enumeration date
10/10/2016
Last updated
12/11/2025
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