| Snellville Oral Surgery Llc | |
|
2221 Knollwood Drive Snellville GA 30078 | |
| (770) 972-7911 | |
| (770) 978-3767 |
| Full Name | Snellville Oral Surgery Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2221 Knollwood Drive, Snellville, Georgia |
| Authorized Official Name and Position | Dale Ellis (OWNER) |
| Authorized Official Contact | 7709727911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Snellville Oral Surgery Llc 2221 Knollwood Drive Snellville GA 30078 Ph: (770) 972-7911 | Snellville Oral Surgery Llc 2221 Knollwood Drive Snellville GA 30078 Ph: (770) 972-7911 |
| NPI Number | 1487837423 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 02/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487837423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN012320 (Georgia) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 07968 (Georgia) | Primary |
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