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Provider Information for 1295931475



JALPA HARVADAN DAVE DMD

Gender: FEMALE

Individual NPI: 1295931475

Calendar Last Updated: 2009-05-08

Details

Name Value
NPI 1295931475
Enumeration Date 2007-06-25
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 805 GLYNN ST S SUITE#131
FAYETTEVILLE, GA 30214-2000
United States

Phone: 770-460-6651 | Fax:
View Map External Link
Primary Practice Address 805 GLYNN ST S SUITE#131
FAYETTEVILLE, GA 30214-2000
United States

Phone: 770-460-6651 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist GA DN013579