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Individual

DR. MARIDITH G DE JESUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
3525 BUSBEE DR NW, KENNESAW, GA 30144-5677
(678) 836-2115
Mailing address
308 COALTER WAY, DECATUR, GA 30030-3321
(973) 647-5897

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123034
GA
1223G0001X
General Practice Dentistry
DN22274
FL
1223G0001X
General Practice Dentistry
DN2274
FL

Other

Enumeration date
05/22/2007
Last updated
08/09/2023
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