Individual
DR. MARIE ELISABETH DETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1686 EATONTON RD, MADISON, GA 30650-4628
(706) 342-0550
(706) 342-3736
Mailing address
1686 EATONTON RD, MADISON, GA 30650-4628
(706) 342-0550
(706) 342-3736
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013560
GA
Other
Enumeration date
06/14/2007
Last updated
08/20/2010
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