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Organization
ASSOCIATED ORAL SPECIALITES
Active
Organization
ASSOCIATED ORAL SPECIALITES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDDIE JAMES WAKEFIELD JR. DMD (OWNER)
(770) 375-0375
Entity
Organization
Contact information
Practice address
5671 PEACHTREE DUNWOODY RD, SUITE 420, ATLANTA, GA 30342-5000
(770) 375-0375
Mailing address
5671 PEACHTREE DUNWOODY RD, SUITE 420, ATLANTA, GA 30342-5000
(770) 375-0375
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/29/2017
Last updated
04/29/2017
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