Healthcare Provider Details

I. General information

NPI: 1164340816
Provider Name (Legal Business Name): LIZA D. SPRATLING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2357 GA HIGHWAY 88
HEPHZIBAH GA
30815-4630
US

IV. Provider business mailing address

PO BOX 263
HEPHZIBAH GA
30815-0263
US

V. Phone/Fax

Practice location:
  • Phone: 706-592-9551
  • Fax:
Mailing address:
  • Phone: 706-834-5045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LIZA DELL SPRATLING
Title or Position: OWNER
Credential:
Phone: 706-834-5045