Provider Demographics
NPI:1730255290
Name:SHOLOTA, CHRIS (DDS)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:SHOLOTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9590 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5987
Mailing Address - Country:US
Mailing Address - Phone:770-814-7080
Mailing Address - Fax:770-814-7090
Practice Address - Street 1:9590 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE C
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5987
Practice Address - Country:US
Practice Address - Phone:770-814-7080
Practice Address - Fax:770-814-7090
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA97811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice