Individual
PAUL DOMINIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
16B FELTON PL, CARTERSVILLE, GA 30120-2152
(770) 382-3536
(770) 382-1915
Mailing address
16B FELTON PL, CARTERSVILLE, GA 30120-2152
(770) 382-3536
(770) 382-1915
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013383
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/20/2006
Last updated
05/16/2016
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