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Individual

SURAJ VANMALI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2285 PEACHTREE RD NE STE 203, ATLANTA, GA 30309-1121
(404) 842-7200
Mailing address
8304 CHEROKEE BLVD, DOUGLASVILLE, GA 30134-2535
(678) 557-3463

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9464
SC

Other

Enumeration date
07/29/2019
Last updated
02/03/2021
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