Dr. Jose Fajardo, D.M.D
Dentist in Norcross, GA. Individual provider (NPI-1).
NPI number1124423934
StatusActive
Last updated in NPPESOct 23, 2014
Details
- NPI
- 1124423934
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jose Fajardo
- Credential
- D.M.D
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 23, 2014
- Last updated
- Oct 23, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 011347 | GA | Yes |
Practice location
5720 Buford HwySuite 101
Norcross, GA 30071-2577
Phone 770-368-1818
Mailing address
5720 Buford HwySuite 101
Norcross, GA 30071-2577
Phone 770-368-1818
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