| Gwinnett Oral & Maxillofacial Surgery, Pc | |
|
171 Gwinnett Dr Suite B Lawrenceville GA 30045-5686 | |
| (770) 995-7960 | |
| Not Available |
| Full Name | Gwinnett Oral & Maxillofacial Surgery, Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 171 Gwinnett Dr, Lawrenceville, Georgia |
| Authorized Official Name and Position | S Lyle Zuck (PRESIDENT) |
| Authorized Official Contact | 7709957960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gwinnett Oral & Maxillofacial Surgery, Pc 171 Gwinnett Dr Suite B Lawrenceville GA 30045-5686 Ph: (770) 995-7960 | Gwinnett Oral & Maxillofacial Surgery, Pc 171 Gwinnett Dr Suite B Lawrenceville GA 30045-5686 Ph: (770) 995-7960 |
| NPI Number | 1205014578 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 02/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205014578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN013444 (Georgia) | Primary |
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