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Individual

DESTINY HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5435 JEFFERSON RD STE 400, ATHENS, GA 30607-1732
(706) 247-8800
Mailing address
1910 SHELDON LN, CONYERS, GA 30094-2000
(901) 634-8714

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123878
GA
390200000X
Student in an Organized Health Care Education/Training Program
TN

Other

Enumeration date
05/09/2025
Last updated
07/29/2025
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