Individual
AMIR GHALEHGOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5252 ROSWELL RD, ATLANTA, GA 30342-1969
(404) 252-5252
Mailing address
5252 ROSWELL RD, ATLANTA, GA 30342-1969
(404) 252-5252
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014472
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN014472
STATE LICENSE
GA
Enumeration date
04/11/2012
Last updated
10/01/2014
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