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General NPI Number Information
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NPI Number | 1780893016
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Entity Type | Individual
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Provider Name | MANASI JAGDISH PAI D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 11585 JONES BRIDGE RD SUITE 710
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City | JOHNS CREEK
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State | GA
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Zip | 30022-8129
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Country | US
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Telephone | 404-937-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 5302 SPALDING MILL PL
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City | NORCROSS
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State | GA
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Zip | 30092-7609
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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 |
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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 | DN012957
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License Number State | GA
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