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Individual

DR. KYANDUKHTA B KALANTARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1350 WOOTEN LAKE RD NW, SUITE 203, KENNESAW, GA 30144-1344
(678) 275-2066
(678) 275-2074
Mailing address
1350 WOOTEN LAKE RD NW, SUITE 203, KENNESAW, GA 30144-1344
(678) 275-2066
(678) 275-2074

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013605
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154041182L
GA
Enumeration date
07/23/2007
Last updated
10/10/2008
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