Organization
DR. VIVIAN LE FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICKI MANTUANO (OFFICE MANAGER)
(770) 898-9191
Entity
Organization
Contact information
Practice address
378 JONESBORO RD, MCDONOUGH, GA 30253-3797
(770) 898-9191
Mailing address
378 JONESBORO RD, MCDONOUGH, GA 30253-3797
(770) 898-9191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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