Individual
DR. ALI SAM AZADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12385 CRABAPPLE RD STE 100, ALPHARETTA, GA 30004-6357
(770) 664-1999
Mailing address
12385 CRABAPPLE RD STE 100, ALPHARETTA, GA 30004-6357
(770) 664-1999
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN122696
GA
390200000X
Student in an Organized Health Care Education/Training Program
DN122696
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/07/2022
Last updated
10/15/2024
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