Organization
SOH OF GEORGIA OZF PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY WEBER (SUPPORT SPECIALIST)
(314) 753-8154
Entity
Organization
Contact information
Practice address
5836 BUFORD HWY STE B, NORCROSS, GA 30071-2581
(770) 300-0031
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(314) 753-8154
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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