Individual
RAVEN VALISHA REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1699 DULUTH HWY, LAWRENCEVILLE, GA 30043-5010
(770) 338-1963
Mailing address
7235 RAND DR, DOUGLASVILLE, GA 30135-5628
(678) 387-0249
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122869
GA
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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