Provider Demographics
NPI:1457462715
Name:NWOSU, DEBORAH N
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:N
Last Name:NWOSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 OLD FLOWERY BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-5618
Mailing Address - Country:US
Mailing Address - Phone:770-532-1111
Mailing Address - Fax:770-532-8835
Practice Address - Street 1:2420 OLD FLOWERY BRANCH RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-5618
Practice Address - Country:US
Practice Address - Phone:770-532-1111
Practice Address - Fax:770-532-8835
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN132061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice