Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN015276 | GA |
NPI | 1003305251 |
---|---|
Provider Name | Hannah Isabel Alexander |
First Address | Smyrna, GA 30080 |
Second Address | Smyrna, GA 30080-9245 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2013 |
Last Update Date | 03/05/2018 |