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General NPI Number Information
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NPI Number | 1205360377
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Entity Type | Organization
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Legal Business Name | ALPHARETTA PEDIATRIC AND FAMILY DENTISTRY PC
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Dates
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Enumeration Date | 04/17/2017
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 8560 HOLCOMB BRIDGE RD STE 119
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City | ALPHARETTA
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State | GA
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Zip | 30022-5322
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Country | US
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Telephone | 770-642-9824
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Fax |
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Provider Business Mailing Address
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Address Line | 8560 HOLCOMB BRIDGE RD STE 119
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City | ALPHARETTA
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State | GA
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Zip | 30022-5322
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Country | US
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Telephone | 770-642-9824
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHISH VAKHARIA
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Credential | DMD
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Telephone | 412-716-7907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN010318
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN015112
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN013218
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License Number State | GA
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