Individual
DR. TRACY ELLEN DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
145 TRADERS WAY, SUITE D, POOLER, GA 31322-6005
(912) 748-4494
Mailing address
145 TRADERS WAY, SUITE D, POOLER, GA 31322-6005
(912) 748-4494
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011541
GA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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