Individual
KHUSHBU MODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3885 MUNDY MILL RD STE 116, OAKWOOD, GA 30566-3432
(832) 622-6290
Mailing address
1160 S MICHIGAN AVE APT 1802, CHICAGO, IL 60605-2864
(832) 622-6290
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30059
TX
122300000X
Dentist
Primary
DN015958
GA
Other
Enumeration date
07/25/2014
Last updated
09/24/2019
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