Provider Demographics
NPI:1144368267
Name:COATES, PAULA L (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:L
Last Name:COATES
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 MACLAND RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-1202
Mailing Address - Country:US
Mailing Address - Phone:770-222-1344
Mailing Address - Fax:770-222-1345
Practice Address - Street 1:4150 MACLAND RD
Practice Address - Street 2:SUITE 205
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-1202
Practice Address - Country:US
Practice Address - Phone:770-222-1344
Practice Address - Fax:770-222-1345
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0128431223P0221X
GADNES0000141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA960015756BMedicaid
GA1005445OtherDORAL
GA96001575EMedicaid
GA960015756DMedicaid
GA96001575EMedicaid
GA960015756BMedicaid