| Northside Oral Surgery Center Llc | |
|
4700 Chamblee Dunwoody Rd Atlanta GA 30338-6054 | |
| (770) 393-8500 | |
| (770) 393-8855 |
| Full Name | Northside Oral Surgery Center Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4700 Chamblee Dunwoody Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Mike Cole (VP INSURANCE PLAN MANAGEMENT) |
| Authorized Official Contact | 9419553150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Oral Surgery Center Llc 4700 Chamblee Dunwoody Rd Atlanta GA 30338-6054 Ph: (770) 393-8500 | Northside Oral Surgery Center Llc 4700 Chamblee Dunwoody Rd Atlanta GA 30338-6054 Ph: (770) 393-8500 |
| NPI Number | 1891252227 |
|---|---|
| Provider Enumeration Date | 02/21/2019 |
| Last Update Date | 02/21/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891252227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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