Organization
ATLANTA ORAL & FACIAL SURGERY LLC
Active
Parent organization
ATLANTA ORAL & FACIAL SURGERY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATLANTA ORAL & FACIAL SURGERY
Authorized official
NANCY HANCOCK (CREDENTIALING)
(770) 356-0489
Entity
Organization
Contact information
Practice address
1000 JOHNSON FERRY RD BLDG H, MARIETTA, GA 30068-5518
(770) 977-0364
Mailing address
121 MARBLE MILL RD NW STE 203, MARIETTA, GA 30060-7959
(770) 356-0489
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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