Individual
DR. CANISHA HOWARD SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1699 DULUTH HWY UNIT 103, LAWRENCEVILLE, GA 30043-5010
(770) 338-1963
Mailing address
1699 DULUTH HWY # 103, LAWRENCEVILLE, GA 30043-5010
(770) 338-1963
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN016161
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/18/2019
Last updated
09/03/2021
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