Individual
LENA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1046 BRASELTON VILLAGE PKWY, BRASELTON, GA 30517-2643
(706) 954-5161
Mailing address
184 AUBURN CROSSING DR, AUBURN, GA 30011-5517
(480) 327-8260
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123892
GA
122300000X
Dentist
DN30544
FL
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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