NPI age
19 years
Enumerated 2007-03-28
Across 48 active oral & maxillofacial surgery providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | DN010907 | LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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