Organization
PLASTIC SURGERY OF GWINNETT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALVIN I ROSENTHAL MD (PRESIDENT)
(770) 682-3375
Entity
Organization
Contact information
Practice address
575 PROFESSIONAL DR STE 285, LAWRENCEVILLE, GA 30046-3355
(770) 682-3375
(770) 682-3387
Mailing address
575 PROFESSIONAL DR STE 285, LAWRENCEVILLE, GA 30046-3355
(770) 682-3375
(770) 682-3387
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
039926
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40BBBBD
PTAN
—
Enumeration date
09/28/2012
Last updated
01/30/2024
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