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Organization

MAHANT DENTAL LLC

Active
Parent organization
MAHANT DENTAL LLC
Other names
Perry Family Dentist
Organization subpart
Yes

Provider details

NPI number
Legal business name
MAHANT DENTAL LLC
Authorized official
KELLEY HALVORSEN (INSURANCE ADMINISTRATOR)
(727) 686-3773
Entity
Organization

Contact information

Practice address
5396 FLOYD RD SW, MABLETON, GA 30126-2216
(770) 941-7588
(770) 941-2119
Mailing address
1411 CROMWELL DR APT SUITE, TARPON SPRINGS, FL 34689-3017
(727) 686-3773

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
11/02/2021
Last updated
11/02/2021
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