IndividualActive
Alisa Nelson-Wade
NPI 1144460668 · General Practice Dentistry · Grayson, GA
Provider details
- NPI number
- 1144460668
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 12336 (GA)
Specialties & taxonomies
Dental Providers
Practice location
2219 Loganville Hwy
Hwy 20
Grayson, GA 30017
Phone: (678) 377-1800
Fax: (678) 377-0740
Approximate (ZIP-level) locationGet directions
Mailing address
2219 Loganville Hwy
Grayson, GA 30017-1622
Registry dates
- Enumerated
- 2009-02-24
- Last updated
- 2009-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.