Individual
SABITHA CHACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4325 ATLANTA HWY #9, LOGANVILLE, GA 30052
(770) 466-0918
Mailing address
2095 CHARLESTON OAK CIRCLE, LAWRENCEVILLE, GA 30043
(336) 338-0382
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123107
GA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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