Organization
MAXFACESURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI CHANDRAN (OWNER)
(601) 208-9064
Entity
Organization
Contact information
Practice address
125 WITHERIDGE DR, DULUTH, GA 30097-7816
(470) 223-7292
(888) 919-3051
Mailing address
125 WITHERIDGE DR, DULUTH, GA 30097-7816
(470) 223-7292
(888) 919-3051
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
07/01/2022
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