Individual
DR. LATONYA F. R. GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1910 HIGHWAY 20 SE STE 100, CONYERS, GA 30013-2074
(404) 729-5159
Mailing address
210 SHORELINE DR, FAYETTEVILLE, GA 30215-4665
(404) 729-5159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN014891
GA
1223G0001X
General Practice Dentistry
Primary
DN014891
GA
Other
Enumeration date
10/23/2014
Last updated
05/30/2019
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