Organization
DASOG LLC
Active
Other names
Whitlock Avenue Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAHESHVAR PATEL DDS (OWNER)
(770) 422-5614
Entity
Organization
Contact information
Practice address
1075 WHITLOCK AVE SW, SUITE C, MARIETTA, GA 30064-1941
(770) 422-5614
Mailing address
1075 WHITLOCK AVE SW, SUITE C, MARIETTA, GA 30064-1941
(770) 422-5614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014121
GA
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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