Healthcare Provider Details

I. General information

NPI: 1437889268
Provider Name (Legal Business Name): SHARIQ ZAFRANI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 OLD NORCROSS RD
LAWRENCEVILLE GA
30046-4317
US

IV. Provider business mailing address

2249 FISHER TRL NE
ATLANTA GA
30345-3432
US

V. Phone/Fax

Practice location:
  • Phone: 770-995-7616
  • Fax:
Mailing address:
  • Phone: 404-643-4185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN122671
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: