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General NPI Number Information
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NPI Number | 1982061123
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Entity Type | Organization
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Legal Business Name | MHMC ORTHODONTICS OF ATLANTA, LLC
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 8200 ROBERTS DR SUITE 550
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City | ATLANTA
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State | GA
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Zip | 30350-4147
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Country | US
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Telephone | 770-351-7737
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Fax | 678-638-6201
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Provider Business Mailing Address
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Address Line | 8200 ROBERTS DR SUITE 550
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City | ATLANTA
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State | GA
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Zip | 30350-4147
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Country | US
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Telephone | 770-351-7737
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Fax | 678-638-6201
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | DR. PRAMOD SINHA
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Credential | DDS, BDS, MS
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Telephone | 509-869-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN015084
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License Number State | GA
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