Individual
DR. LISA G MARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MD
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0001
(706) 721-9744
(706) 721-6778
Mailing address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0001
(706) 721-9744
(706) 721-6778
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
046876
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN010898
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02530936
—
NY
Enumeration date
10/05/2006
Last updated
02/19/2026
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