Organization
KRAGOR ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMBRE ANN KRAGOR DDS, MS (ORTHODONTIST)
(206) 854-8585
Entity
Organization
Contact information
Practice address
1816 EAGLE DR, SUITE 100-B, WOODSTOCK, GA 30189-8272
(206) 854-8585
Mailing address
1816 EAGLE DR, SUITE 100-B, WOODSTOCK, GA 30189-8272
(206) 854-8585
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN014935
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN014936
GA
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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