Organization
GOFS MCDONOUGH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHROKH BAGHERI DMD, MD (OWNER)
(678) 905-9066
Entity
Organization
Contact information
Practice address
125 WESTRIDGE INDUSTRIAL BLVD, SUITE 303, MCDONOUGH, GA 30253-9098
(678) 304-6494
Mailing address
1880 W OAK PKWY, SUITE 111, MARIETTA, GA 30062-2272
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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