SHIVANE K GUPTA

LILBURN, GA
NPI1295046399
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
(Licence: GA  078309)
Enumeration Date2010-06-24
Last Update Date2022-07-06
Business Address
Dr. SHIVANE K GUPTA MD
4150 FIVE FORKS TRICKUM RD SW STE 1
LILBURN, GA 30047-3130
Phone number: 770-717-7225
Mailing Address
Dr. SHIVANE K GUPTA MD
4150 FIVE FORKS TRICKUM RD SW STE 1
LILBURN, GA 30047-3130
Phone number: 770-717-7225