Individual
MRS. LEPORSCHE MARQUITA CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 DENTAL DR STE 11, WARNER ROBINS, GA 31088-8216
(478) 334-2091
Mailing address
205 DENTAL DR STE 11, WARNER ROBINS, GA 31088-8216
(478) 334-2091
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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