Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 12009 | GA |
NPI | 1144343880 |
---|---|
Provider Name | Dr. Daniel Charles Garabadian |
First Address | Cumming, GA 30040-9238 |
Second Address | Cumming, GA 30040-9238 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 08/07/2007 |