Individual
DR. JESSICA MINDY FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
328 MARGIE DR, WARNER ROBINS, GA 31088-8933
(478) 971-7701
Mailing address
4860 GA HIGHWAY 56 N, WAYNESBORO, GA 30830-7022
(770) 601-7421
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123215
GA
Other
Enumeration date
08/03/2023
Last updated
08/03/2023
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