Individual
AMANDA KOMISAROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
6990 LAUREL OAK DR, SUWANEE, GA 30024-5338
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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