Provider Demographics
NPI:1023677275
Name:GOING, GABRIELLE LINA (DMD)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:LINA
Last Name:GOING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 13TH ST NE APT 1415
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4594
Mailing Address - Country:US
Mailing Address - Phone:404-345-7181
Mailing Address - Fax:
Practice Address - Street 1:2405 SATELLITE BLVD STE 115
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-9022
Practice Address - Country:US
Practice Address - Phone:770-622-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0158521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice