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1902068372
NATASHA ALEXIS LISIN-QUEEN
ACWORTH, GA
NPI
1902068372
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: GA DN014359)
Additional Taxonomies
122300000X Dentist
(Licence: MA 22194)
Enumeration Date
2008-06-27
Last Update Date
2015-11-23
Business Address
Dr. NATASHA ALEXIS LISIN-QUEEN DMD
3950 COBB PKWY NW SUITE 402
ACWORTH, GA 30101-9532
Phone number: 770-966-9396
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Mailing Address
Dr. NATASHA ALEXIS LISIN-QUEEN DMD
230 CHICKERING LAKE DR
ROSWELL, GA 30075-3278
Phone number: 314-498-9006
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