BASU BANSTOLA

TUCKER, GA
NPI1891197810
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy122300000X Dentist
(Licence: PA  DS040169)
Enumeration Date2014-09-22
Last Update Date2021-12-01
Business Address
Dr. BASU BANSTOLA
2315 BROCKETT RD
TUCKER, GA 30084-4412
Phone number: 770-934-1698
Mailing Address
Dr. BASU BANSTOLA
PO BOX 2635
TUCKER, GA 30085-2635
Phone number: 404-704-2088
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