Provider Demographics
NPI:1518123439
Name:LEMONS, MARNITA LOVE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARNITA
Middle Name:LOVE
Last Name:LEMONS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARNITA
Other - Middle Name:L'TRESE
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6351 DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-7102
Mailing Address - Country:US
Mailing Address - Phone:770-577-9478
Mailing Address - Fax:770-577-9425
Practice Address - Street 1:6351 DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-7102
Practice Address - Country:US
Practice Address - Phone:770-577-9478
Practice Address - Fax:770-577-9425
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013758122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist