Individual
EMMA DEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4150 FIVE FORKS TRICKUM RD SW, LILBURN, GA 30047-3130
(770) 717-7225
Mailing address
5755 GLENRIDGE DR, ATLANTA, GA 30328-5551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015840
GA
Other
Enumeration date
06/12/2019
Last updated
06/12/2019
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