Provider Demographics
NPI:1336632454
Name:LEMOINE, DANIELA OLIVEIRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:OLIVEIRA
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 JOHNSON FERRY RD STE 164
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6499
Mailing Address - Country:US
Mailing Address - Phone:470-795-6677
Mailing Address - Fax:470-795-6678
Practice Address - Street 1:1401 JOHNSON FERRY RD STE 164
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6499
Practice Address - Country:US
Practice Address - Phone:470-795-6677
Practice Address - Fax:470-795-6678
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0156751223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice