Individual
DANA LEEANN WORTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DA
Contact information
Practice address
4150 MACLAND RD STE 205, POWDER SPRINGS, GA 30127-8212
(770) 222-1344
(770) 222-1345
Mailing address
2749 ELKHART CIR SW, MARIETTA, GA 30064-4319
(770) 882-6594
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/16/2010
Last updated
09/16/2010
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