Individual
ELISSE MACKAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
995 BAXTER ST, ATHENS, GA 30606-3705
(706) 546-8480
Mailing address
1011 SAINT ANDREWS DR, WATKINSVILLE, GA 30677-7740
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN015988
GA
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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