Provider Demographics
NPI:1740480227
Name:LALANI, FIROZ
Entity type:Individual
Prefix:
First Name:FIROZ
Middle Name:
Last Name:LALANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2785 LAWRENCEVILLE HWY
Mailing Address - Street 2:STE 103
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2515
Mailing Address - Country:US
Mailing Address - Phone:770-491-1132
Mailing Address - Fax:850-837-2042
Practice Address - Street 1:2785 LAWRENCEVILLE HWY
Practice Address - Street 2:STE 103
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2515
Practice Address - Country:US
Practice Address - Phone:770-491-1132
Practice Address - Fax:850-837-2042
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0135551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice