Individual
ALLEN MICAJAH VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
369 E BROAD ST, WINDER, GA 30680-2278
(770) 867-2277
(770) 868-5988
Mailing address
369 E BROAD ST, WINDER, GA 30680-2278
(770) 867-2277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122424
GA
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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