Organization
ICLEAR ORTHODONTICS AND BRACES LLC
Active
Other names
Orthodontic excellence
Organization subpart
No
Provider details
NPI number
Authorized official
RUCHIR PATEL DDS (MANAGER)
(770) 914-2808
Entity
Organization
Contact information
Practice address
420 MCDONOUGH PKWY, MCDONOUGH, GA 30253-8946
(770) 914-2808
Mailing address
420 MCDONOUGH PKWY, MCDONOUGH, GA 30253-8946
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN014542
GA
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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