Individual
DR. STACEY LYLE ZUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
945 RIVER CENTRE PL, SUITE 100, LAWRENCEVILLE, GA 30043-7340
(770) 995-7960
(770) 995-7367
Mailing address
945 RIVER CENTRE PL, SUITE 100, LAWRENCEVILLE, GA 30043-7340
(770) 995-7960
(770) 995-7367
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN031444
GA
Other
Enumeration date
01/30/2006
Last updated
11/25/2008
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