Organization
PEACHTREE DUNWOODY ORAL AND FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IRENE IVERSON (INSURANCE ADMINISTRATOR)
(404) 220-7505
Entity
Organization
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD, SUITE 660, ATLANTA, GA 30342-1705
(404) 220-7505
(404) 220-7506
Mailing address
5505 PEACHTREE DUNWOODY RD, SUITE 660, ATLANTA, GA 30342-1705
(404) 220-7505
(404) 220-7506
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN010345
GA
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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