| Ks Gasm, Pc | |
|
5158 Memorial Dr Stone Mountain GA 30083-3111 | |
| (770) 916-9000 | |
| Not Available |
| Full Name | Ks Gasm, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5158 Memorial Dr, Stone Mountain, Georgia |
| Authorized Official Name and Position | Tu Tran (OWNER) |
| Authorized Official Contact | 4042296943 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ks Gasm, Pc 400 Galleria Pkwy Se Ste 800 Atlanta GA 30339-5934 Ph: (770) 916-5028 | Ks Gasm, Pc 5158 Memorial Dr Stone Mountain GA 30083-3111 Ph: (770) 916-9000 |
| NPI Number | 1295949659 |
|---|---|
| Provider Enumeration Date | 05/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295949659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN012562 (Georgia) | Primary |
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