Individual provider · Type 1 NPI
Dereka McKissack McKissack
Dental Assistant · Stone Mountain, GA
Practice location
374 N Deshon Rd Ste D
Stone Mountain, GA 30087-4827
Fax (770) 469-4195
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Assistant Primary | 126800000X | None listed |
Dental Assistant: An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the d…
About NPI 1124469705
Dereka McKissack McKissack's National Provider Identifier is 1124469705, issued on Jul 11, 2013. The primary taxonomy on file is Dental Assistant (126800000X), and the practice location is in Stone Mountain, GA. The record was last updated on Jul 11, 2013.