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Search › Georgia › General Practice Dentistry

Nicole Widjaja, DMD

NPI 1063259356 · on the registry since 2024

Practice

Address
1350 Upper Hembree Rd
Roswell, GA 30076
Phone
(678) 920-7675
Organisation at this address
Village Podiatry Group, Llc.
Village Podiatry Group, Llc.
Ehi Pharmacy Solutions, Llc.
Village Podiatry Group, L.L.C.
Benchmark Healthcare Services Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
7

Registry record

Primary taxonomy
General Practice Dentistry
1223G0001X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-07-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia