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General NPI Number Information
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NPI Number | 1194271445
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Entity Type | Individual
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Provider Name | DINA AMIN
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 11/09/2017
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Provider Practice Location Address
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Address Line | 1365 CLIFTON,BUILDING B, ORAL AND MAXILLOFACIAL SURGERY SUITE 2300
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City | ATLANTA
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State | GA
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Zip | 30322
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Country | US
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Telephone | 205-566-0435
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Fax |
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Provider Business Mailing Address
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Address Line | 1258 DEKALB AVENUE NE UNITE 108
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City | ATLANTA
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State | GA
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Zip | 30307
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Country | US
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Telephone | 470-421-7024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DNF000393
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License Number State | GA
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