Organization
NORTHWEST ORAL & MAXILLOFACIAL SURGERY ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL A. DAVILA (PRESIDENT)
(770) 422-7630
Entity
Organization
Contact information
Practice address
55 WHITCHER ST NE, SUITE 140, MARIETTA, GA 30060-1155
(770) 422-7630
(770) 422-6017
Mailing address
55 WHITCHER ST NE, SUITE 140, MARIETTA, GA 30060-1155
(770) 422-7630
(770) 422-6017
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/02/2006
Last updated
06/22/2015
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