Individual
KIA-SYMONE SURRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
500 INDIANA AVE, WINSLOW, AZ 86047-2169
(928) 289-4646
Mailing address
3179 ABBEY DR SW, ATLANTA, GA 30331-5477
(510) 927-7161
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
05/28/2024
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