MEDICARE: DR. SWATI M KANDALKAR DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21658	MA
2	1223G0001X	General Practice Dentistry	DN014239	GA

General Provider Information

NPI Number	:	1508903048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SWATI M KANDALKAR DMD

Provider Business Mailing Address
First Line	:	3210 BRIARCLIFF GABLES CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-2446
Country	:	US
Telephone Number	:	845-699-8079
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 CORPORATE BLVD NE STE 120
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30329-1905
Country	:	US
Telephone Number	:	678-836-2120
Fax Number	:	404-320-9552

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	01/08/2018

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