Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH043887 | GA |
NPI | 1053908913 |
---|---|
Provider Name | D'angela Lashaun Franklin |
First Address | Ellenwood, GA 30294-3048 |
Second Address | Atlanta, GA 30329-3011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2020 |
Last Update Date | 28/12/2020 |