Organization
MCDONOUGH PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VISHANT NATH DMD (DENTIST)
(770) 651-1000
Entity
Organization
Contact information
Practice address
420 MCDONOUGH PKWY, MCDONOUGH, GA 30253-8946
(770) 651-1000
Mailing address
420 MCDONOUGH PARKWAY, MCDONOUGH, GA 30253
(770) 651-1000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013057
GA
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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