Provider Demographics
NPI:1215171707
Name:ARDESHNA, TORAL N (DDS)
Entity type:Individual
Prefix:DR
First Name:TORAL
Middle Name:N
Last Name:ARDESHNA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9205 COLEMAN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4740
Mailing Address - Country:US
Mailing Address - Phone:770-906-5502
Mailing Address - Fax:
Practice Address - Street 1:9205 COLEMAN RD STE 200
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-4740
Practice Address - Country:US
Practice Address - Phone:678-321-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013868122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist