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Individual

ELISABETH BAERTLEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4463 TOWNE LAKE PKWY, SUITE 200, WOODSTOCK, GA 30189-8229
(678) 445-1105
Mailing address
2502 N ROCKY POINT DR, SUITE 1000-CREDENTIALING, TAMPA, FL 33607-1421

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012941
GA

Other

Enumeration date
09/01/2006
Last updated
09/02/2010
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