| Organization Name: | MAGUALIE J. WOOLLERY, D.M.D., P.C. |
| NPI Number: | 1023135738 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAGUALIE JOSEPH WOOLLERY (OWNER) |
| Mailing Address: | 7760 Hampton Pl Building 6 Loganville |
| State: | GA US |
| Postal Code: | 300526770 |
| Phone Number: | 6786390080 |
| Fax Number: | 6786390088 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 06/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DN012142 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |