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Individual

LILA GUEVARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
410 N JEFF DAVIS DR, FAYETTEVILLE, GA 30214-1630
(678) 228-8348
Mailing address
77 12TH ST NE UNIT 2201, ATLANTA, GA 30309-4084
(678) 571-3339

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122482
GA

Other

Enumeration date
09/01/2021
Last updated
09/01/2021
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