Individual
MS. MICHELLE JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1853 PEELER RD, SUITE A, DUNWOODY, GA 30338-5714
(770) 391-9212
(770) 698-9929
Mailing address
1853 PEELER RD, SUITE A, DUNWOODY, GA 30338-5714
(770) 391-9212
(770) 698-9929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012455
GA
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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