MS. Dereka McKissack McKissack
MS. Dereka McKissack McKissack is a Dental Assistant in Stone Mountain, Georgia. Practices as a sole proprietor. Registered with an NPI since 2013.
- In the registry since
- 2013
Practice location Address checks out
374 N Deshon Rd Ste DStone Mountain, GA 30087-4827
Phone: (770) 469-4192
Fax: (770) 469-4195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dental Assistant (primary) | Taxonomy 126800000X |
|---|
Record details
| NPI number | 1124469705 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | July 11, 2013 |
| Last updated in NPPES | July 11, 2013 |