Individual
KANU PRIYA GOEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 NEWNAN CROSSING BYPASS, NEWNAN, GA 30263-2401
(678) 621-6410
(678) 423-0228
Mailing address
236 LAGRANGE COURT 236 LAGRANGE COURT, MACON, GA 31210
(718) 920-4321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015312
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/16/2015
Last updated
07/21/2022
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