BANSTOLA

TUCKER, GA
NPI1114685740
Entity TypeOrganization
Authorized ContactBASU BANSTOLA
Owner Dentist
770-934-1698
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2021-12-01
Last Update Date2021-12-01
Business Address
BANSTOLA
2315 BROCKETT RD
TUCKER, GA 30084-4412
Phone number: 770-934-1698
Mailing Address
BANSTOLA
PO BOX 2635
TUCKER, GA 30085-2635
Phone number:
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