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Individual

ASHLEY MEGAN GAGNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD, MD

Contact information

Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-4500
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-2000

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DN123028
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
17634
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/01/2022
Last updated
01/19/2026
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