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DR. REGINALD DOUGLAS BOOKER D.D.S.
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1699711416
Individual Registrant:DR. REGINALD DOUGLAS BOOKER D.D.S.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
4005 WINDER HWY #100 FLOWERY BRANCH, GA 30542-6564 US
Tel: 770-531-3232 Fax: --
Tel: 770-531-3232 Fax: --
Contact information for business:
4005 WINDER HWY STE. 110 FLOWERY BRANCH, GA 30542-6564 US
Tel: 770-531-3232 Fax: --
Tel: 770-531-3232 Fax: --
Registration Information:
NPI: 1699711416
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | GA | DN013464 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 813355373A | GA | 05 |
