Provider Demographics
NPI:1689343279
Name:COBB ROOT CANALS
Entity Type:Organization
Organization Name:COBB ROOT CANALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHERWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SARAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-996-6949
Mailing Address - Street 1:3535 ROSWELL RD STE 56
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-8828
Mailing Address - Country:US
Mailing Address - Phone:678-996-6949
Mailing Address - Fax:470-689-3976
Practice Address - Street 1:3535 ROSWELL RD STE 56
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-8828
Practice Address - Country:US
Practice Address - Phone:678-996-6949
Practice Address - Fax:470-689-3976
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COBB ROOT CANALS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty