Organization
NORTHSIDE ORAL SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(941) 955-3150
Entity
Organization
Contact information
Practice address
4700 CHAMBLEE DUNWOODY RD, ATLANTA, GA 30338-6054
(770) 393-8500
(770) 393-8855
Mailing address
4700 CHAMBLEE DUNWOODY RD, ATLANTA, GA 30338-6054
(770) 393-8500
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/21/2019
Last updated
02/21/2019
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