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General NPI Number Information
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NPI Number | 1487445029
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Entity Type | Individual
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Provider Name | TERESA SKINNER
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 1000 JOHNSON FERRY RD BLDG H
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City | MARIETTA
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State | GA
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Zip | 30068-5518
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Country | US
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Telephone | 770-977-0364
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Fax |
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Provider Business Mailing Address
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Address Line | 273 SHELTON CIR
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City | TEMPLE
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State | GA
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Zip | 30179-5495
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Country | US
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Telephone | 770-634-8904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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