Individual provider · Type 1 NPI

Waunelle Jackson Ian, DDS

General Practice Dentistry · Marietta, GA

NPI number 1811006471 Active

About NPI 1811006471

Waunelle Jackson Ian, DDS's National Provider Identifier is 1811006471, issued on Aug 29, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Marietta, GA. The record was last updated on Jul 8, 2007.