| North Georgia Oral Surgery & Dental Implants | |
|
3400 Mcclure Bridge Road Building G Suite B Duluth GA 30096 | |
| (770) 476-8576 | |
| (770) 623-9714 |
| Full Name | North Georgia Oral Surgery & Dental Implants |
|---|---|
| Speciality | Dentist |
| Location | 3400 Mcclure Bridge Road, Duluth, Georgia |
| Authorized Official Name and Position | Glen C Mcintosh (PRESIDENT) |
| Authorized Official Contact | 7704768576 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Georgia Oral Surgery & Dental Implants 3400 Mcclure Bridge Road Building G Suite B Duluth GA 30096 Ph: (770) 476-8576 | North Georgia Oral Surgery & Dental Implants 3400 Mcclure Bridge Road Building G Suite B Duluth GA 30096 Ph: (770) 476-8576 |
| NPI Number | 1356528558 |
|---|---|
| Provider Enumeration Date | 01/30/2008 |
| Last Update Date | 01/30/2008 |
| Medicare PECOS PAC ID | 9739084005 |
|---|---|
| Medicare Enrollment ID | O20031201000600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356528558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Glen C Mcintosh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1285793372 PECOS PAC ID: 3072418243 Enrollment ID: I20080204000614 |
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