Individual
MS. SYRETTA WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4930 GOVERNORS DR, SUITE 405, FOREST PARK, GA 30297-6101
(404) 363-1700
(404) 363-0700
Mailing address
4930 GOVERNORS DR, SUITE 405, FOREST PARK, GA 30297-6101
(404) 363-1700
(404) 363-0700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN13505
GA
1223P0700X
Prosthodontics
Primary
DN13505
GA
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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