Individual
DR. KASRA NEZAFAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 WHITE ST NW, MARIETTA, GA 30060-1058
(770) 517-1224
Mailing address
5112 VERBENA DR NW, ACWORTH, GA 30102-6923
(678) 699-9978
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015645
GA
Other
Enumeration date
06/05/2018
Last updated
06/05/2018
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