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1114685740
BANSTOLA
TUCKER, GA
NPI
1114685740
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Entity Type
Organization
Authorized Contact
BASU BANSTOLA
Owner Dentist
770-934-1698
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2021-12-01
Last Update Date
2021-12-01
Business Address
BANSTOLA
2315 BROCKETT RD
TUCKER, GA 30084-4412
Phone number: 770-934-1698
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Mailing Address
BANSTOLA
PO BOX 2635
TUCKER, GA 30085-2635
Phone number:
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