Individual
DR. KIRAN KAMDAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BDS, MSD, PC
Contact information
Practice address
5460 LILBURN STONE MOUNTAIN RD, STONE MOUNTAIN, GA 30087-2843
(770) 923-2232
(770) 923-2268
Mailing address
5460 LILBURN STONE MOUNTAIN RD, STONE MOUNTAIN, GA 30087-2843
(770) 923-2232
(770) 923-2268
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN010597
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00412079A
—
GA
01
—
827601
UNITED CONCORDIA NUMBER
GA
01
—
DN010597
GEORGIA LICENSE NUMBER
GA
Enumeration date
04/25/2007
Last updated
09/19/2024
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