Provider Demographics
NPI:1396103537
Name:RANA, HIRA (DMD)
Entity type:Individual
Prefix:
First Name:HIRA
Middle Name:
Last Name:RANA
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 1:1721 POWDER SPRINGS RD SW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4879
Mailing Address - Country:US
Mailing Address - Phone:770-293-0605
Mailing Address - Fax:
Practice Address - Street 1:1721 POWDER SPRINGS RD SW
Practice Address - Street 2:SUITE 103
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4879
Practice Address - Country:US
Practice Address - Phone:770-293-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015118122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist