Northwest Oral & Maxillofacial Surgery Associates, P.c. | |
55 Whitcher St Ne Suite 140 Marietta GA 30060-1155 | |
(770) 422-7630 | |
(770) 422-6017 |
Full Name | Northwest Oral & Maxillofacial Surgery Associates, P.c. |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 55 Whitcher St Ne, Marietta, Georgia |
Authorized Official Name and Position | Manuel A. Davila (PRESIDENT) |
Authorized Official Contact | 7704227630 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Northwest Oral & Maxillofacial Surgery Associates, P.c. 55 Whitcher St Ne Suite 140 Marietta GA 30060-1155 Ph: (770) 422-7630 | Northwest Oral & Maxillofacial Surgery Associates, P.c. 55 Whitcher St Ne Suite 140 Marietta GA 30060-1155 Ph: (770) 422-7630 |
NPI Number | 1194732735 |
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Provider Enumeration Date | 08/02/2006 |
Last Update Date | 06/22/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194732735 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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