Individual
GODLIVE ATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5005 RIVERSIDE DR STE A, MACON, GA 31210-1380
(478) 405-0664
Mailing address
110 PEACH BLOSSOM ROAD # 140, BONAIRE, GA 31005
(786) 541-4431
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123932
GA
Other
Enumeration date
07/08/2025
Last updated
08/19/2025
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