Canton Marketplace Dentistry LLC

NPI #1891267316 in Canton, Georgia

Provider Information

NPI Number: 1891267316
Entity Type: Organization
Organization Name: Canton Marketplace Dentistry LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 21, 2018
Last Updated: Dec 21, 2018

Practice Location

Address: 1810 CUMMING HWY STE 900
City: Canton
State: Georgia
ZIP Code: 30115-2999
Phone: (770) 780-2465

Authorized Official

Name: POYA M MOGHADAM
Title: OWNER
Phone: (678) 880-0087

Specialties & Taxonomy Codes

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

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