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Individual

DR. HEATHER VICTORINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
175 COUNTRY CLUB DR BLDG 300B, STOCKBRIDGE, GA 30281-7388
(678) 565-9452
(678) 565-9484
Mailing address
259 ARROWHEAD BLVD, SUITE B-2, JONESBORO, GA 30236-1167

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013227
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175566289A
GA
Enumeration date
01/04/2007
Last updated
10/10/2023
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