Individual
ELYSE M. MORCEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
205 HAWKINS STORE RD NW, SUITE 100, KENNESAW, GA 30144-6215
(770) 926-3400
(770) 926-6317
Mailing address
1203 FAWNDALE DR NW, KENNESAW, GA 30152-3958
(404) 509-4145
(770) 451-5112
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN012309
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000896629D
—
GA
Enumeration date
02/02/2006
Last updated
01/24/2017
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