| Lana L. Mamut, Dmd, Pc | |
|
3130 Mathis Airport Pkwy Ste 309 Suwanee GA 30024-9131 | |
| (404) 579-0519 | |
| Not Available |
| Full Name | Lana L. Mamut, Dmd, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3130 Mathis Airport Pkwy, Suwanee, Georgia |
| Authorized Official Name and Position | Lana Lvovna Mamut (OWNER DENTIST) |
| Authorized Official Contact | 4045790519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lana L. Mamut, Dmd, Pc 3130 Mathis Airport Pkwy Ste 309 Suwanee GA 30024-9131 Ph: (404) 579-0519 | Lana L. Mamut, Dmd, Pc 3130 Mathis Airport Pkwy Ste 309 Suwanee GA 30024-9131 Ph: (404) 579-0519 |
| NPI Number | 1437487550 |
|---|---|
| Provider Enumeration Date | 12/01/2009 |
| Last Update Date | 07/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437487550 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN012943 (Georgia) | Primary |
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