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Antoinette Theodore, PA-C

NPI 1558882381 · on the registry since 2017

Practice

Address
5635 Peachtree Pkwy Ste 180
Peachtree Corners, GA 30092
Phone
(470) 938-6670
Fax
(678) 272-3144
Organisation at this address
Origin Dental Llc
Peachtree Corners Dental Associates
Inferred from a shared address, not stated in the registry.
Clinicians at this address
9

Additional practice sites

  • 105 Iver Pl Apt 325, Fayetteville, GA

Registry record

Primary taxonomy
363AM0700X
363AM0700X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-01-26

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