Organization
ICLEAR ORTHODONTICS AND BRACES NORTH LLC
Active
Other names
Orthodontic excellence
Organization subpart
No
Provider details
NPI number
Authorized official
KALPESHKUMAR THAKKAR DDS (MANAGER)
(770) 448-0494
Entity
Organization
Contact information
Practice address
5635 PEACHTREE PKWY, SUITE 200, NORCROSS, GA 30092-2879
(770) 448-0494
Mailing address
5635 PEACHTREE PKWY, SUITE 200, NORCROSS, GA 30092-2879
(770) 448-0494
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN014522
GA
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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