Individual
JAISHANKAR THIRUMALAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1806 OVER LAKE DR SE, CONYERS, GA 30013-1745
(770) 760-7900
(770) 760-1375
Mailing address
5130 DAVIDSON RD, MARIETTA, GA 30068
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013405
GA
Other
Enumeration date
11/01/2006
Last updated
08/18/2008
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