Individual
DR. MARIE OLIVIA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
99 JESSE HILL JR DR SE, ATLANTA, GA 30303
(404) 730-1471
(404) 730-1475
Mailing address
300 GEMSTONE PLACE, COLLEGE PARK, GA 30349-8432
(770) 991-3323
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
009527
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00257727E
—
GA
05
—
00257727N
—
GA
Enumeration date
11/07/2006
Last updated
07/09/2007
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