Organization
ORAL AND FACIAL SURGERY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT E ELLIS DDS (MANAGING PARTNER)
(770) 962-9515
Entity
Organization
Contact information
Practice address
745 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4317
(770) 962-9515
(770) 962-2722
Mailing address
745 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4317
(770) 962-9515
(770) 962-2722
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN009242
GA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
DN009242
GA
Other
Enumeration date
07/30/2006
Last updated
04/14/2026
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