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Organization

SOUTHEAST ORAL DIAGNOSTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHANIE WETZEL (OWNER/ DENTIST)
(770) 992-4844
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary

Other

Enumeration date
01/05/2026
Last updated
01/05/2026
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