Individual
MRS. STACEY LEIGH GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
229 PEACHTREE ST NE, SUITE 206, ATLANTA, GA 30303-1601
(404) 522-7913
Mailing address
1788 FRIAR TUCK RD NE, ATLANTA, GA 30309-2614
(404) 875-9675
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7359
GA
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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