NPI 1003054156

Jesse Hader, DDS

Practitioner Dentist Atlanta, GA

Practice location

Address: 3648 Peachtree Rd NE Penthouse 4-S, Atlanta, GA 30319-1255
Phone: (404) 842-1196
Fax: (404) 842-1198

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence DN006221 (GA)

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Registry record

NPI: 1003054156
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jan 2009
Record last updated: 28 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.