Individual
J. RENA OWSLEY-BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1275 HIGHWAY 54 W, SUITE 204, FAYETTEVILLE, GA 30214-4549
(770) 461-5500
(770) 461-1033
Mailing address
1275 HIGHWAY 54 W, SUITE 204, FAYETTEVILLE, GA 30214-4549
(770) 461-5500
(770) 461-1033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012893
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
791041331A
—
GA
Enumeration date
07/10/2006
Last updated
07/08/2007
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