Provider Demographics
NPI:1386335354
Name:JOHNS, GARLAND ANDREW
Entity type:Individual
Prefix:
First Name:GARLAND
Middle Name:ANDREW
Last Name:JOHNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:448 CENTRAL WAY
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-7327
Mailing Address - Country:US
Mailing Address - Phone:706-459-4023
Mailing Address - Fax:
Practice Address - Street 1:201 S PARK AVE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2441
Practice Address - Country:US
Practice Address - Phone:706-623-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN1231521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice