Individual
BUHLEBENKOSI PRISCA MABANDLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1090 NORTHCHASE PKWY SE STE 290, MARIETTA, GA 30067-6402
(202) 520-7469
Mailing address
1090 NORTHCHASE PKWY SE STE 290, MARIETTA, GA 30067-6402
(202) 520-7469
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
31473
TX
1223G0001X
General Practice Dentistry
Primary
16593
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2014
Last updated
07/21/2022
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