Organization
GA OMS SDS PC
Active
Parent organization
GA OMS SDS PC
Other names
Signature Dental Implants and Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
GA OMS SDS PC
Authorized official
CHARLOTTE DASCH (SR. DIRECTOR OF CREDENTIALING)
(504) 638-0303
Entity
Organization
Contact information
Practice address
1380 PEACHTREE INDUSTRIAL BLVD STE 100, SUWANEE, GA 30024-3793
(770) 232-1191
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(504) 638-0303
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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