Organization
GA SPECIALTY DENTAL SERVICES
Active
Parent organization
GA SPECIALTY DENTAL SERVICES, PC
Other names
Southwest Oral and Maxillofacial Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
GA SPECIALTY DENTAL SERVICES, PC
Authorized official
CHARLOTTE V DASCH (DIREC OF CRED AND PROV REL)
(504) 638-0303
Entity
Organization
Contact information
Practice address
620 POINTE NORTH BLVD, ALBANY, GA 31721-1590
(229) 878-3610
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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