# SOUTHEAST ORAL DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063378966
- **Authorized official:** DR. STEPHANIE WETZEL (OWNER/ DENTIST)
- **Authorized official phone:** (770) 992-4844

## Contact information

- **Practice address:** 282 RUCKER RD STE 110, ALPHARETTA, GA 30004-5826
- **Practice address phone:** (770) 992-4844
- **Mailing address:** 346 PRESTON AVE, LEXINGTON, KY 40502-1532
- **Mailing address phone:** (770) 992-4844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | NULL | Yes |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/05/2026
- **Last updated:** 01/05/2026