Provider Demographics
NPI:1770718553
Name:REFAI, ANNA MAGDALENA (DMD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MAGDALENA
Last Name:REFAI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GALLERIA PKWY
Mailing Address - Street 2:SUITE 1830
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339
Mailing Address - Country:US
Mailing Address - Phone:770-955-0550
Mailing Address - Fax:770-955-7770
Practice Address - Street 1:200 GALLERIA PKWY
Practice Address - Street 2:SUITE 1830
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:770-955-0550
Practice Address - Fax:770-955-7770
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0141151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics