Individual
JIGAR ASHOK DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
919 PINE COVE DR, LILBURN, GA 30047-1401
(770) 401-4190
Mailing address
919 PINE COVE DR, LILBURN, GA 30047-1401
(770) 401-4190
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
15473
MD
1223G0001X
General Practice Dentistry
Primary
DN015742
GA
Other
Enumeration date
07/19/2013
Last updated
12/15/2018
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