Individual
SUNDAY A FAWOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2395 SCENIC HWY S, SNELLVILLE, GA 30078-3134
(678) 377-6830
(678) 377-6836
Mailing address
2395 SCENIC HWY S, SNELLVILLE, GA 30078-3134
(678) 377-6830
(678) 377-6836
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO12698
GA
207QA0505X
Adult Medicine Physician
55514
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
586073644E
—
GA
Enumeration date
11/07/2006
Last updated
02/21/2022
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