Individual
DR. NISHA MANIAR KANCHERLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
320 KILLIAN HILL RD NW, LILBURN, GA 30047-3809
(770) 921-3555
Mailing address
3644 VIA NUOVA LN, SUWANEE, GA 30024-5044
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN015970
GA
1223P0300X
Periodontics
DS039792
PA
Other
Enumeration date
11/07/2013
Last updated
08/09/2022
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