Individual
ANTHONY BHANSALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3643 WALTON WAY EXT, AUGUSTA, GA 30909-4507
(706) 738-7129
(706) 738-6684
Mailing address
2048 KINSMON DR, MARIETTA, GA 30062-8139
(770) 286-2292
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
123279
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123279
GEORGIA BOARD OF DENTISTRY
GA
Enumeration date
11/06/2023
Last updated
11/06/2023
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