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CHARISSE L. CASWELL DMD

Pediatric Dentistry >> Dentist >> Dental Providers

Registrant NPI Number: 1326013921

Individual Registrant:
 CHARISSE L. CASWELL DMD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
120 HANDLEY RD SUITE 210 TYRONE, GA 30290-2177 US
Tel: 770-632-7090  Fax: 770-632-7075

Contact information for business:
120 HANDLEY RD SUITE 210 TYRONE, GA 30290-2177 US
Tel: 770-632-7090  Fax: 770-632-7075

Registration Information:
NPI: 1326013921
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223P0221XDental Providers
Dentist
Pediatric Dentistry
GADN013163
N1223G0001XDental Providers
Dentist
GADN013163

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
773054619GGA05
773054619HGA05




HEALTH CARE JOBS GA - Page 1



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