Organization
SOUTHERN DENTAL SNELLVILLE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISHNA PATEL DMD (DENTIST)
(404) 429-5371
Entity
Organization
Contact information
Practice address
1550 JANMAR RD, SUITE A, SNELLVILLE, GA 30078
(404) 429-5371
Mailing address
225 EAGLES LANDING WAY, MCDONOUGH, GA 30253-4221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN014512
GA
332BC3200X
Customized Equipment (DME)
DN014512
GA
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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