Individual
DR. MAURICE J FAGAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., DMD
Contact information
Practice address
5555 PEACHTREE DUNWOODY RD NE, SUITE 140, ATLANTA, GA 30342-1703
(404) 255-5006
(404) 257-1201
Mailing address
5555 PEACHTREE DUNWOODY RD NE, SUITE 140, ATLANTA, GA 30342-1703
(404) 255-5006
(404) 257-1201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
GA 9340
GA
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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