Individual
DR. JUAN CARLOS HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3705 OLD NORCROSS RD STE 300, DULUTH, GA 30096-4336
(770) 813-0777
(770) 813-1023
Mailing address
3705 OLD NORCROSS RD STE 300, DULUTH, GA 30096-4336
(347) 228-4321
(770) 813-1023
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN013633
GA
1223G0001X
General Practice Dentistry
DN013633
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN013633
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669652152
—
GA
Enumeration date
11/13/2007
Last updated
08/31/2022
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