| Creekside Oral Surgery Inc | |
|
10700 Medlock Bridge Rd Ste 204 Johns Creek GA 30097-8455 | |
| (770) 764-0840 | |
| Not Available |
| Full Name | Creekside Oral Surgery Inc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 10700 Medlock Bridge Rd Ste 204, Johns Creek, Georgia |
| Authorized Official Name and Position | Nkemakonam Egolum (OWNER) |
| Authorized Official Contact | 7707640840 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Creekside Oral Surgery Inc 10700 Medlock Bridge Rd Ste 204 Johns Creek GA 30097-8455 Ph: () - | Creekside Oral Surgery Inc 10700 Medlock Bridge Rd Ste 204 Johns Creek GA 30097-8455 Ph: (770) 764-0840 |
| NPI Number | 1992586143 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 10/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992586143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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