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Individual

DR. CRYSTAL HAYES PREMPEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S, MPH

Contact information

Practice address
5255 STILESBORO RD NW, SUITE 110, KENNESAW, GA 30152-7737
(770) 499-2152
Mailing address
30 GILMER WAY, ACWORTH, GA 30101

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
28408
TX
1223P0221X
Pediatric Dentistry
28408
TX
1223P0221X
Pediatric Dentistry
9909
NC
1223P0221X
Pediatric Dentistry
Primary
DN015291
GA

Other

Enumeration date
01/16/2013
Last updated
05/31/2017
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