Individual
DR. REGINALD GARY WOODELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7571 HIGHWAY 78, WINSTON, GA 30187-1449
(404) 933-6031
Mailing address
7571 HIGHWAY 78, WINSTON, GA 30187-1449
(404) 933-6031
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8104
GA
1223P0700X
Prosthodontics
Primary
8104
GA
Other
Enumeration date
02/22/2009
Last updated
02/22/2009
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