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Individual

DR. SERGEY GAZAROV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
351 W 6TH STREET, BLDG 440, USA DENTAL HEALTH ACTIVITY, FORT STEWART, GA 31314
(912) 435-6249
Mailing address
BLDG 38717 38TH STREET, USA DENTAC, FORT GORDON, GA 30905
(706) 787-6927

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
62674
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9549
SC
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
61302962
WA

Other

Enumeration date
09/12/2013
Last updated
12/24/2022
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