Individual
DR. KENNETH LEE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1229 WILDCLIFF PKWY NE, ATLANTA, GA 30329-3464
(404) 323-3419
Mailing address
1229 WILDCLIFF PKWY NE, ATLANTA, GA 30329-3464
(404) 323-3419
Taxonomy
Speciality
Code
Description
License number
State
1744R1102X
Research Study Specialist
Primary
G66887
CA
Other
Enumeration date
07/05/2012
Last updated
07/05/2012
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