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Individual

LINA WARDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2055 BEAVER RUIN RD, NORCROSS, GA 30071-3648
(770) 242-0021
Mailing address
329 PARC RIVER BLVD, LAWRENCEVILLE, GA 30046-4015

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015513
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2039338
KAISER
GA
Enumeration date
09/27/2017
Last updated
06/16/2018
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