Individual
GREG A SHOUP
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3294 MEDLOCK BRIDGE RD, NORCROSS, GA 30092-3082
(770) 448-8882
(770) 446-5511
Mailing address
3294 MEDLOCK BRIDGE RD, NORCROSS, GA 30092-3082
(770) 448-8882
(770) 446-5511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN009834
GA
Other
Enumeration date
06/05/2006
Last updated
07/08/2007
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