Individual
DORSA KAVIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4360 IVYWOOD DR, MARIETTA, GA 30062-6431
(678) 381-6012
Mailing address
4360 IVYWOOD DR, MARIETTA, GA 30062-6431
(678) 381-6012
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123135
GA
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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