Individual
EVIS BABO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2045 PEACHTREE RD NE, SUITE 100, ATLANTA, GA 30309-1414
(404) 605-0359
(404) 605-0678
Mailing address
2045 PEACHTREE RD NE, SUITE 100, ATLANTA, GA 30309-1414
(404) 605-0359
(404) 605-0678
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12399
GA
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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