Individual
ANNE DEATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
144 S COLUMBIA DR, DECATUR, GA 30030-4103
(404) 328-7171
Mailing address
7803 AMBER GLEN CT, LOUISVILLE, KY 40220-1578
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122293
GA
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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