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General NPI Number Information
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NPI Number | 1275036410
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Entity Type | Individual
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Provider Name | YASMINE RASSAM
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Gender | Female
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 11125 JONES BRIDGE RD STE 200
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City | ALPHARETTA
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State | GA
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Zip | 30022-0002
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Country | US
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Telephone | 678-274-6965
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Fax |
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Provider Business Mailing Address
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Address Line | 6005 STATE BRIDGE RD APT 933
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City | DULUTH
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State | GA
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Zip | 30097-6458
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Country | US
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Telephone | 404-917-4494
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN015560
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License Number State | GA
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