Individual
ANAIS MARIA AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5218 JIMMY LEE SMITH PKWY, HIRAM, GA 30141-2747
(770) 439-1038
Mailing address
5218 JIMMY LEE SMITH PKWY STE 100, HIRAM, GA 30141-2747
(770) 439-1038
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015548
GA
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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