Individual
JANET SUSAN ELLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
125 EAGLES POINTE PKWY, SUITE 210, STOCKBRIDGE, GA 30281-6379
(770) 507-7282
(770) 692-0651
Mailing address
295 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-7350
(770) 473-1350
(770) 692-0098
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN010677
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000745665A
—
GA
Enumeration date
07/26/2006
Last updated
09/05/2012
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