Individual
NATASHA MOFRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1825 MARS HILL RD NW, ACWORTH, GA 30101-4518
(770) 422-9375
Mailing address
1825 MARS HILL RD NW, ACWORTH, GA 30101-4518
(770) 422-9375
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN123659
GA
1223D0001X
Public Health Dentistry
11549
NC
1223G0001X
General Practice Dentistry
10246
SC
1223G0001X
General Practice Dentistry
11549
NC
Other
Enumeration date
08/21/2019
Last updated
03/17/2025
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