Individual
POYA MOGHADAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1810 CUMMING HWY, SUITE 900, CANTON, GA 30114-9386
(678) 880-0087
(678) 880-0059
Mailing address
1810 CUMMING HWY, SUITE 900, CANTON, GA 30114-9386
(678) 880-0087
(678) 880-0059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DNO13583
GA
Other
Enumeration date
08/16/2007
Last updated
11/15/2010
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