Organization
PRESTON GANTT, MD, SA-C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRESTON GANTT MD, SA-C (OWNER)
(770) 580-4929
Entity
Organization
Contact information
Practice address
5330 BROOKSTONE DR NW STE 250, ACWORTH, GA 30101-7183
(770) 580-4929
Mailing address
5330 BROOKSTONE DR NW STE 250, ACWORTH, GA 30101-7183
(770) 580-4929
(949) 561-5102
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
07/05/2018
Last updated
04/26/2021
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