Individual
DANA E NELSON WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2000 RIVERSIDE PARKWAY, SUITE 200, GREAT EXPRESSIONS DENTAL CENTERS OF GEORGIA, PC, LAWRENCEVILLE, GA 30043
(202) 487-5044
Mailing address
2000 RIVERSIDE PARKWAY, SUITE 200, GREAT EXPRESSIONS DENTAL CENTERS OF GEORGIA, PC, LAWRENCEVILLE, GA 30043
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
8670
NC
1223G0001X
General Practice Dentistry
8670
NC
1223G0001X
General Practice Dentistry
DN013754
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5916374
—
NC
Enumeration date
01/20/2010
Last updated
01/23/2019
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