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Organization
PEACHTREE DUNWOODY ORAL AND FACIAL SURGERY
Active
Organization
PEACHTREE DUNWOODY ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IRENE IVERSON (INSURANCE ADMINISTRATOR)
(404) 220-7505
Entity
Organization
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD, SUITE 660, ATLANTA, GA 30342-1705
(404) 220-7505
(404) 220-7506
Mailing address
5505 PEACHTREE DUNWOODY RD, SUITE 660, ATLANTA, GA 30342-1705
(404) 220-7505
(404) 220-7506
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN010345
GA
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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