Provider Demographics
NPI:1700298734
Name:DAWSON, KRISTINA MOHME (DMD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MOHME
Last Name:DAWSON
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 1:5635 PEACHTREE PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2879
Mailing Address - Country:US
Mailing Address - Phone:770-448-5666
Mailing Address - Fax:
Practice Address - Street 1:5635 PEACHTREE PKWY STE 220
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2823
Practice Address - Country:US
Practice Address - Phone:770-501-6669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014429122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist