Individual
DR. RACQUEL LEWIS VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3983 LAVISTA RD STE 104, TUCKER, GA 30084-5140
(770) 723-1111
Mailing address
3983 LAVISTA RD STE 104, TUCKER, GA 30084-5140
(770) 723-1111
(770) 723-9444
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN014917
GA
1223G0001X
General Practice Dentistry
Primary
DN014917
GA
1223G0001X
General Practice Dentistry
DN19195
FL
Other
Enumeration date
08/19/2010
Last updated
07/12/2022
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