Individual
STACEY MARIE MCDOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
865 S CARROLL RD STE C, VILLA RICA, GA 30180-7056
(770) 459-4131
Mailing address
146 CREEKRISE PL, PALMETTO, GA 30268-2096
(404) 884-9195
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15411
GA
1223G0001X
General Practice Dentistry
DN015411
GA
Other
Enumeration date
06/15/2017
Last updated
02/19/2023
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