Individual
LISA CALLOWAY DJERNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
965 BATTLEFIELD PKWY, FORT OGLETHORPE, GA 30742-3945
(706) 866-8412
Mailing address
824 HUNTERS POINTE LN, BOWLING GREEN, KY 42104-7211
(423) 322-3191
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10710
KY
1223G0001X
General Practice Dentistry
DN016094
GA
Other
Enumeration date
08/28/2020
Last updated
07/07/2022
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