Provider Demographics
NPI:1376763953
Name:CVETKOVIC, DAWN C (LAC)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:C
Last Name:CVETKOVIC
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6165 LAKEAIRES DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-1109
Mailing Address - Country:US
Mailing Address - Phone:678-896-9609
Mailing Address - Fax:678-896-9609
Practice Address - Street 1:309 PIRKLE FERRY RD
Practice Address - Street 2:SUITE A-400
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2545
Practice Address - Country:US
Practice Address - Phone:678-648-1371
Practice Address - Fax:678-648-1371
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC7981171100000X
CA14687 DIPL.AC.2083P0901X
GA0002372083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine