Organization
ORAL SURGERY OF WEST COBB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE GUFFIN (ADMINSITRATOR)
(770) 499-2152
Entity
Organization
Contact information
Practice address
5255 STILESBORO RD NW, STE 120, KENNESAW, GA 30152-7737
(770) 499-2152
(770) 499-2157
Mailing address
5255 STILESBORO RD NW, STE 120, KENNESAW, GA 30152-7737
(770) 499-2152
(770) 499-2157
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN013572
GA
Other
Enumeration date
03/06/2012
Last updated
03/06/2012
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