Individual
SHAYNA ARIEL TILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, CDA, EFDA
Contact information
Practice address
1875 OLD ALABAMA RD STE 130, ROSWELL, GA 30076-2262
(770) 998-3838
Mailing address
150 KENSINGTON POND CT, ROSWELL, GA 30075-5579
(770) 634-9664
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH044019
GA
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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