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Provider Information for 1295931475

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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
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist GA DN013579
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location