Individual
WAYNE THEODORE TADSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
102 GORDON ST, LAWRENCEVILLE, GA 30045-6910
(770) 995-6215
(770) 995-6263
Mailing address
102 GORDON ST, LAWRENCEVILLE, GA 30045-6910
(770) 995-6215
(770) 995-6263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN008626
GA
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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