Individual
LYDIA YOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1805 EPPS BRIDGE PKWY STE 101, ATHENS, GA 30606-6127
(706) 549-0108
Mailing address
1035 MCKENDREE PARK LN, LAWRENCEVILLE, GA 30043-6252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN122844
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/11/2022
Last updated
10/27/2022
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