Individual
KATRINA CO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4030 WINDER HWY, FLOWERY BRANCH, GA 30542-3021
(678) 960-3440
Mailing address
4030 WINDER HWY, FLOWERY BRANCH, GA 30542-3021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN22808
FL
122300000X
Dentist
DS041871
PA
1223G0001X
General Practice Dentistry
Primary
DN122218
GA
Other
Enumeration date
03/11/2017
Last updated
03/09/2021
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