Individual
JESSICA MITCHUM RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
814 RADFORD BLVD BLDG 7000, ALBANY, GA 31704-1130
(229) 639-7886
Mailing address
142 DADFORD DR, LEESBURG, GA 31763-5801
(865) 293-9918
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11925
TN
Other
Enumeration date
07/11/2022
Last updated
05/19/2025
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