Organization
ICLEAR ORTHODONTICS AND BRACES NORTH LLC
Active
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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