Kallie Law Brock, D.M.D.

NPI #1447596655 in Canton, Georgia

Provider Information

NPI Number: 1447596655
Entity Type: Individual
Name: Kallie Law Brock, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Dec 14, 2012
Last Updated: Feb 15, 2015

Practice Location

Address: 205 WALESKA RD
Address 2: SUITE 2A
City: Canton
State: Georgia
ZIP Code: 30114-2493
Phone: (770) 479-3713

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary
Dentist	122300000X

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