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General NPI Number Information
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NPI Number | 1356886394
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Entity Type | Organization
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Legal Business Name | AESTHETICS HAIR RESTORATION LLC
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 12/29/2016
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Provider Practice Location Address
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Address Line | 11975 MORRIS RD SUITE 220
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City | ALPHARETTA
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State | GA
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Zip | 30005-4419
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Country | US
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Telephone | 678-691-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 11975 MORRIS RD SUITE 220
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City | ALPHARETTA
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State | GA
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Zip | 30005-4419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAHROKH BAGHERI
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Credential | DMD, MD
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Telephone | 678-691-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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