Organization
GEORGIA ORAL AND FACIAL SURGERY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA AGUILAR (MANAGER)
(404) 806-1762
Entity
Organization
Contact information
Practice address
1880 W OAK PKWY, SUITE 215, MARIETTA, GA 30062-2272
(404) 806-1762
Mailing address
1880 W OAK PKWY, SUITE 215, MARIETTA, GA 30062-2272
(404) 806-1762
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
054541
GA
Other
Enumeration date
06/09/2010
Last updated
06/09/2010
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