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General NPI Number Information
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NPI Number | 1659444073
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Entity Type | Individual
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Provider Name | AFSHAN SYEDA SHAHANA BINTORY D.M.D
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 1235 INDIAN TRAIL LILBURN RD SUITE# 300
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City | NORCROSS
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State | GA
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Zip | 30093-5524
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Country | US
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Telephone | 678-735-8168
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Fax | 770-729-8262
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Provider Business Mailing Address
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Address Line | 6041 NORCROSS GLEN TRCE
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City | NORCROSS
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State | GA
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Zip | 30071-1811
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Country | US
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Telephone | 678-735-8168
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Fax | 770-729-8262
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN013016
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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 | DN013016
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License Number State | GA
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