Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN010772 | GA |
NPI | 1649263948 |
---|---|
Provider Name | Dr. Toya Dotson Greene |
First Address | Marietta, GA 30008-4010 |
Second Address | Marietta, GA 30008-4010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 08/07/2007 |