GODLIVE ATHIS
Individual Provider (NPI-1)
Active
Dentist, General Practice
Provider Information
- NPI Number
1922998236- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 5005 RIVERSIDE DR STE A, MACON, GA, 312101380
- Phone
- (478) 405-0664
Specialties & Taxonomies
Dentist, General Practice
Primary License: GA #DN123932