# GWINNETT CENTER FOR ORAL & MAXILLOFACIAL SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093619462
- **Authorized official:** MR. ASIF TAUFIG DDS (OWNER)
- **Authorized official phone:** (770) 962-0515

## Contact information

- **Practice address:** 15 COLLINS INDUSTRIAL WAY, SUITE B, LAWRENCEVILLE, GA 30043
- **Practice address phone:** (770) 962-0515
- **Practice address fax:** (770) 962-1244
- **Mailing address:** 15 COLLINS INDUSTRIAL WAY, SUITE B, LAWRENCEVILLE, GA 30043
- **Mailing address phone:** (770) 962-0515
- **Mailing address fax:** (770) 962-1244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |

## Other

- **Enumeration date:** 10/07/2026
- **Last updated:** 10/07/2026