Individual
DR. MARY WOLFE DOORNBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
135 JOHNSON FERRY RD, SUITE 2210, MARIETTA, GA 30068-4942
(404) 353-6651
Mailing address
2227 AUSTIN LAKE DR SE, SMYRNA, GA 30082-3381
(706) 518-3032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8938
KY
1223G0001X
General Practice Dentistry
DN013886
GA
1223P0221X
Pediatric Dentistry
Primary
DN013886
GA
Other
Enumeration date
06/17/2009
Last updated
01/24/2014
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