Provider Demographics
NPI:1871731638
Name:MUSICER, WENDY ALISON (DMD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ALISON
Last Name:MUSICER
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 1:1650 OAKBROOK DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1881
Mailing Address - Country:US
Mailing Address - Phone:770-446-8000
Mailing Address - Fax:770-446-1354
Practice Address - Street 1:9775 MEDLOCK BRIDGE RD STE I
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5986
Practice Address - Country:US
Practice Address - Phone:770-476-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-31
Last Update Date:2009-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0137411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice