Individual
ELAINE C POWALKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1970 HABERSHAM MARINA RD, CUMMING, GA 30041
(404) 234-9232
Mailing address
1970 HABERSHAM MARINA RD, CUMMING, GA 30041-7505
(404) 234-9232
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011621
GA
Other
Enumeration date
12/23/2008
Last updated
12/23/2008
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