Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 9463 | GA |
NPI | 1073697439 |
---|---|
Provider Name | Dr. Henry Edward Paris JR. |
First Address | Columbus, GA 31904-9225 |
Second Address | Columbus, GA 31904-9225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 09/08/2012 |