MEDICARE: DR. SARAH QURESHI IQBAL 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	122300000X	Dentist	DN015052	GA

General Provider Information

NPI Number	:	1578939989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH QURESHI IQBAL DMD

Provider Business Mailing Address
First Line	:	10403 MADISON DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30346-2478
Country	:	US
Telephone Number	:	706-951-6109
Fax Number	:

Provider Business Practice Location Address
First Line	:	4920 ROSWELL RD
Second Line	:	#13A
City	:	ATLANTA
State	:	GA
Zip	:	30342-2686
Country	:	US
Telephone Number	:	404-236-7222
Fax Number	:

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

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	08/19/2015

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