| Ga Sds, Pc | |
|
1380 Peachtree Industrial Blvd Ste 100 Suwanee GA 30024-3793 | |
| (770) 232-1191 | |
| (770) 232-2733 |
| Full Name | Ga Sds, Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1380 Peachtree Industrial Blvd Ste 100, Suwanee, Georgia |
| Authorized Official Name and Position | Charlotte E Vial (DIRECTOR OF CREDENTIALING AND PR) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga Sds, Pc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (615) 678-0759 | Ga Sds, Pc 1380 Peachtree Industrial Blvd Ste 100 Suwanee GA 30024-3793 Ph: (770) 232-1191 |
| NPI Number | 1902679913 |
|---|---|
| Provider Enumeration Date | 11/01/2023 |
| Last Update Date | 11/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902679913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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