DR. Basu Banstola

NPI #1891197810 in Tucker, Georgia

Provider Information

NPI Number: 1891197810
Entity Type: Individual
Name: DR. Basu Banstola
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Sep 22, 2014
Last Updated: Dec 1, 2021

Practice Location

Address: 2315 BROCKETT RD
City: Tucker
State: Georgia
ZIP Code: 30084-4412
Phone: (770) 934-1698

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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