Individual
DR. SHAUN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 DAWSON COMMONS CIR, SUITE 110, DAWSONVILLE, GA 30534-6264
(706) 265-1512
Mailing address
718 WAMOCK DR, ALPHARETTA, GA 30004-0774
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DNO12780
GA
1223P0221X
Pediatric Dentistry
Primary
DNO12780
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226986184A
—
GA
Enumeration date
01/10/2006
Last updated
04/18/2024
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