Individual
NATASHA GANDARILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
BLDG 38801 ACADEMIC DRIVE, FORT GORDON, GA 30905
(216) 659-1670
Mailing address
725 GOODALE DR, AUGUSTA, GA 30909-0095
(216) 659-1670
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
35034
TX
Other
Enumeration date
09/08/2017
Last updated
08/09/2023
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