Provider Demographics
NPI:1689704934
Name:MCCOWN, GIANNA ANGEL
Entity Type:Individual
Prefix:MRS
First Name:GIANNA
Middle Name:ANGEL
Last Name:MCCOWN
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 1:1797 OVERVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-6266
Mailing Address - Country:US
Mailing Address - Phone:678-344-6700
Mailing Address - Fax:404-846-0425
Practice Address - Street 1:45 LENOX POINTE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3162
Practice Address - Country:US
Practice Address - Phone:404-846-0422
Practice Address - Fax:404-846-0425
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADH008205124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist