Individual
MRS. KENYATTA CHICHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2239 HIGHWAY 20 SE STE H, CONYERS, GA 30013-2087
(770) 570-6399
Mailing address
2239 HIGHWAY 20 SE STE H, CONYERS, GA 30013-2087
(770) 570-6399
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH012201
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH012201
DENTAL
GA
Enumeration date
04/03/2020
Last updated
04/03/2020
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