Healthcare Provider Details

I. General information

NPI: 1811195639
Provider Name (Legal Business Name): CAROL POSASDA ANGSTADT D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS CAROL YVETTE POSADA

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 SIXES RD
CANTON GA
30114-7965
US

IV. Provider business mailing address

3237 SIXES RD
CANTON GA
30114-7965
US

V. Phone/Fax

Practice location:
  • Phone: 678-880-9755
  • Fax:
Mailing address:
  • Phone: 678-880-9775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN014746
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: