Individual
ELIZABETH VIRUET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
218 QUARTERMAN ST, WAYCROSS, GA 31501-3547
(912) 287-0301
(912) 287-1568
Mailing address
218 QUARTERMAN ST, WAYCROSS, GA 31501-3547
(912) 287-0301
(912) 287-1568
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D12878
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003145286A
—
GA
Enumeration date
10/17/2008
Last updated
08/08/2016
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