Individual
DR. VISHANT NATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
10930 CRABAPPLE RD, SUITE 106, ROSWELL, GA 30075-5813
(678) 352-1090
(770) 277-5637
Mailing address
2012 IVEY CHASE DR, DACULA, GA 30019-7884
(770) 277-5637
(770) 277-5637
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013057
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DN013057
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
761564386D
—
GA
Enumeration date
02/22/2006
Last updated
10/30/2016
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