Individual
DEQUAN BIVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1455 PLEASANT HILL RD, SUITE 807-A, LAWRENCEVILLE, GA 30044-3045
(770) 925-9045
Mailing address
1455 PLEASANT HILL RD, SUITE 807-A, LAWRENCEVILLE, GA 30044-3045
(770) 925-9045
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013547
GA
Other
Enumeration date
06/08/2007
Last updated
10/07/2008
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