| Ga Oms Sds Pc | |
|
1380 Peachtree Industrial Blvd Ste 100 Suwanee GA 30024-3793 | |
| (770) 232-1191 | |
| Not Available |
| Full Name | Ga Oms Sds Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1380 Peachtree Industrial Blvd Ste 100, Suwanee, Georgia |
| Authorized Official Name and Position | Charlotte Dasch (SR. DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 5046380303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga Oms Sds Pc 1610 54th Ave N Ste 205 Nashville TN 37209-1442 Ph: (504) 638-0303 | Ga Oms Sds Pc 1380 Peachtree Industrial Blvd Ste 100 Suwanee GA 30024-3793 Ph: (770) 232-1191 |
| NPI Number | 1497631378 |
|---|---|
| Provider Enumeration Date | 08/14/2025 |
| Last Update Date | 08/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497631378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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