Individual
DR. LISA NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2239 HIGHWAY 20 SE STE H, CONYERS, GA 30013-2087
(770) 921-3565
Mailing address
1454 DYLAN CHASE, MARIETTA, GA 30066-2712
(404) 769-4788
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN016092
GA
Other
Enumeration date
08/03/2021
Last updated
09/01/2022
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