Hernandez, Juan Carlos

Hernandez, Juan Carlos is an sole proprietor health care provider with primary practice located at 3705 Old Norcross Rd Ste 300 , Duluth GA 30096-4336. He recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Hernandez, Juan Carlos can be contacted via phone (770) 813-0777.

Contact Information

Primary practice address
3705 Old Norcross Rd Ste 300 Duluth GA 30096-4336
Phone: (770) 813-0777
Fax: (770) 813-1023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DN013633 Georgia
Dental Providers / Dentist 122300000X DN013633 Georgia
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DN013633 Georgia

Profile Details

NPI number 1669652152
LBN Legal business name Hernandez, Juan Carlos
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2007
Last updated Aug 31st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669652152 NPPES
Georgia MEDICAID 1669652152

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