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Search › Georgia › Oral & Maxillofacial Surgery (D.M.D.)

Shivane Gupta, MD

NPI 1295046399 · on the registry since 2010 · sole proprietor

Practice

Address
4150 Five Forks Trickum Rd Sw Ste 1
Lilburn, GA 30047
Phone
(770) 717-7225
Fax
(770) 717-7228
Clinicians at this address
4

Registry record

Primary taxonomy
Oral & Maxillofacial Surgery (D.M.D.)
204E00000X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-07-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia