Organization
EAST ATLANTA ORAL, IMPLANT AND FACIAL SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY TARVER DDS (OWNER)
(770) 382-3536
Entity
Organization
Contact information
Practice address
519 MEMORIAL DR SE UNIT D1, ATLANTA, GA 30312-2218
(404) 483-6316
Mailing address
2115 WOLBERT TRL, MARIETTA, GA 30062-7908
(770) 382-3536
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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