Individual
DR. ANISA MARYAM ALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2570 BLACKMON DR STE 310, DECATUR, GA 30033-6197
(678) 203-3462
Mailing address
2570 BLACKMON DR STE 310, DECATUR, GA 30033-6197
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123230
GA
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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