Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN008289 | GA |
Y | 1223P0700X | Prosthodontist | 8289 | GA |
NPI | 1184760472 |
---|---|
Provider Name | Arun Nayyar |
First Address | Roswell, GA 30076-3816 |
Second Address | Roswell, GA 30076-3816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 28/01/2021 |