Individual
TISHA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2230 TOWNE LAKE PKWY, BLDG 1300 STE 100, WOODSTOCK, GA 30189
(678) 445-5444
(678) 445-5552
Mailing address
2230 TOWNE LAKE PKWY, BLDG 1300 STE 100, WOODSTOCK, GA 30189
(678) 445-5444
(678) 445-5552
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
012802
GA
1223P0221X
Pediatric Dentistry
Primary
DN012802
GA
Other
Enumeration date
07/07/2006
Last updated
12/03/2020
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