Organization
FACIAL TRAUMA SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAHROKH BAGHERI DMD MD (OWNER)
(404) 964-6921
Entity
Organization
Contact information
Practice address
2008 LAWRENCEVILLE SUWANEE RD, SUWANEE, GA 30024-2625
(678) 905-9066
Mailing address
1880 W OAK PKWY STE 111, MARIETTA, GA 30062-2274
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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