Individual
AUTUMN VANDIVER REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH,BSDH
Contact information
Practice address
201 NEWNAN CROSSING BYP, NEWNAN, GA 30265-1063
(678) 621-6410
Mailing address
273 THE BLVD, NEWNAN, GA 30263-6254
(770) 328-9834
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH011214
GA
Other
Enumeration date
04/09/2022
Last updated
04/09/2022
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