Anesthesiologists For Dental Sedation LLC
Anesthesiology in Dacula, GA. Organization (NPI-2).
NPI number1235754151
StatusActive
Last updated in NPPESJul 15, 2021
Details
- NPI
- 1235754151
- Entity type
- Organization (NPI-2)
- Legal business name
- Anesthesiologists For Dental Sedation LLC
- Organization subpart
- No
- Enumeration date
- Jun 16, 2020
- Certification date
- Jul 15, 2021
- Last updated
- Jul 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | – | – | Yes |
Other names
- Anesthesiologists For Outpatient Surgery (Other Name)
Practice location
3625 Braselton Hwy Ste 201Dacula, GA 30019-4695
Phone 678-889-2326 · Fax 470-238-3658
Mailing address
3625 Braselton Hwy Ste 201Dacula, GA 30019-4695
Phone 678-889-2326 · Fax 470-238-3658
Authorized official
Cory Kane Mansour
Co-Founding Partner/Owner
6788892326
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