Organization
LANA L. MAMUT, DMD, PC
Active
Other names
Family Dentistry of Forsyth
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LANA LVOVNA MAMUT DMD (OWNER DENTIST)
(404) 579-0519
Entity
Organization
Contact information
Practice address
3130 MATHIS AIRPORT PKWY, STE 309, SUWANEE, GA 30024-9131
(404) 579-0519
Mailing address
3130 MATHIS AIRPORT PKWY, STE 309, SUWANEE, GA 30024-9131
(404) 579-0519
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN012943
GA
Other
Enumeration date
12/01/2009
Last updated
07/29/2013
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