Provider Demographics
NPI:1427149566
Name:PULLINS, CHARLOTTE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:
Last Name:PULLINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 W END AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6805
Mailing Address - Country:US
Mailing Address - Phone:770-314-1240
Mailing Address - Fax:
Practice Address - Street 1:310 W ELM ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-4802
Practice Address - Country:US
Practice Address - Phone:256-262-0200
Practice Address - Fax:770-850-8052
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD-0006727-C122300000X, 1223G0001X
GA0122841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA971788076AMedicaid