Individual
DR. DIANE MANNING PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D., M.D.
Contact information
Practice address
1891 GA HIGHWAY 40 E, SUITE 1104, KINGSLAND, GA 31548-6572
(912) 673-6545
(912) 576-1846
Mailing address
73 HAWTHORN LN, SAINT MARYS, GA 31558-4026
(912) 673-6545
(612) 576-1846
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN011196
GA
Other
Enumeration date
10/20/2006
Last updated
11/19/2015
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