Individual
BROOKE MAHDAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
955 MEMORIAL DR SE STE 530, ATLANTA, GA 30316-1566
(770) 800-5802
Mailing address
55 CHESTER AVE SE, ATLANTA, GA 30316-1201
(239) 940-0867
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN015346
GA
Other
Enumeration date
06/12/2019
Last updated
03/12/2023
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