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General NPI Number Information
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NPI Number | 1518750439
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Entity Type | Organization
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Legal Business Name | CN5, LLC
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Dates
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Enumeration Date | 05/23/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 502 S ENOTA DR NE
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City | GAINESVILLE
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State | GA
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Zip | 30501-2546
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Country | US
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Telephone | 770-531-2522
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Fax | 770-531-2521
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Provider Business Mailing Address
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Address Line | 2790 LAKEWIND CT
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City | ALPHARETTA
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State | GA
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Zip | 30005-4288
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Country | US
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Telephone | 770-820-8052
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RADHIKA KATRAGUNTA
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Credential | DMD
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Telephone | 770-820-8052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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