Healthcare Provider Details

I. General information

NPI: 1740726900
Provider Name (Legal Business Name): HOV PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2859 PACES FERRY RD SE 530
ATLANTA GA
30339
US

IV. Provider business mailing address

2859 PACES FERRY RD SE 530
ATLANTA GA
30339
US

V. Phone/Fax

Practice location:
  • Phone: 678-355-8980
  • Fax:
Mailing address:
  • Phone: 678-355-8980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN013686
License Number StateGA

VIII. Authorized Official

Name: DR. JAY KANSAL
Title or Position: OWNER
Credential: DMD
Phone: 678-521-1888