Individual
DR. ALISA M NELSON-WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2219 LOGANVILLE HWY, HWY 20, GRAYSON, GA 30017
(678) 377-1800
(678) 377-0740
Mailing address
2219 LOGANVILLE HWY, HWY 20, GRAYSON, GA 30017-1622
(678) 377-1800
(678) 377-0740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12336
GA
Other
Enumeration date
02/24/2009
Last updated
02/24/2009
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