Mahant Dental LLC

NPI #1205591526 in Mableton, Georgia

Provider Information

NPI Number: 1205591526
Entity Type: Organization
Organization Name: Mahant Dental LLC
Subpart: Yes (part of a larger organization)
Parent Organization: MAHANT DENTAL LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 2, 2021
Last Updated: Nov 2, 2021

Practice Location

Address: 5396 FLOYD RD SW
City: Mableton
State: Georgia
ZIP Code: 30126-2216
Phone: (770) 941-7588

Authorized Official

Name: KELLEY HALVORSEN
Title: INSURANCE ADMINISTRATOR
Phone: (727) 686-3773

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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