Individual
DOLLY CHANTA'E PENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MSCR
Contact information
Practice address
111 MOUNTAIN BROOK DR STE 100, CANTON, GA 30115-9045
(678) 880-9654
Mailing address
6707 DEMOCRACY BLVD SUITE 800, BETHESDA, MD 20892-5465
(301) 496-8676
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
81812
GA
2083P0901X
Public Health & General Preventive Medicine Physician
D81335
MD
208D00000X
General Practice Physician
81812
GA
Other
Enumeration date
06/18/2009
Last updated
02/25/2025
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