Provider Demographics
NPI:1003905811
Name:MEHTA, RINA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:RINA
Middle Name:M
Last Name:MEHTA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 DALLAS HWY SW
Mailing Address - Street 2:SUITE #401
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-2567
Mailing Address - Country:US
Mailing Address - Phone:770-428-4888
Mailing Address - Fax:770-428-4009
Practice Address - Street 1:2500 DALLAS HWY SW
Practice Address - Street 2:SUITE #401
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-2567
Practice Address - Country:US
Practice Address - Phone:770-428-4888
Practice Address - Fax:770-428-4009
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0126551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice