Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 58-1154976 | GA |
NPI | 1043347891 |
---|---|
Provider Name | Dr. Charles L Abney |
First Address | Decatur, GA 30033-3500 |
Second Address | Decatur, GA 30033-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 25/08/2011 |