Individual
JESSICA TARA NESSMITH PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, QOM, CERTBBM
Contact information
Practice address
5450 COPPER SPRINGS LN, CUMMING, GA 30040-5626
(404) 441-8917
Mailing address
5450 COPPER SPRINGS LN, CUMMING, GA 30040-5626
(404) 441-8917
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH009864
GA
Other
Enumeration date
02/13/2023
Last updated
02/13/2023
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