Individual
MOHAMAD FAWAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1430 JOHN WESLEY GILBERT DRIVE, AUGUSTA, GA 30912-0566
(706) 288-6517
Mailing address
1430 JOHN WESLEY GILBERT DRIVE AUGUSTA, AUGUSTA, GA 30912-0257
(706) 288-6517
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0442000458
VA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
DN123645
VA
Other
Enumeration date
05/25/2022
Last updated
03/24/2025
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