Individual
DR. DANIEL DIBACCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2200 ROSWELL RD, MARIETTA, GA 30062-2983
(770) 973-7337
Mailing address
136 PEACHTREE MEMORIAL DR NW, PENNYSLVANIA #7, ATLANTA, GA 30309-1096
(404) 808-2722
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021517
GA
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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