Individual
DR. AGATHA NKECHI NWIZU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4362 N HENRY BLVD, STOCKBRIDGE, GA 30281-3662
(770) 474-9202
(770) 474-9842
Mailing address
4362 N HENRY BLVD, STOCKBRIDGE, GA 30281-3662
(770) 474-9202
(770) 474-9842
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013176
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
386365697A
—
GA
Enumeration date
08/31/2006
Last updated
08/20/2012
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