Southwest Maxillofacial Surgery & Implant Center
LBN: Southwest Maxillofacial Surgery & Implant Center
Southwest Maxillofacial Surgery & Implant Center is an health care organization with primary practice located at 3885 Princeton Lakes Way Sw 406, Atlanta GA 30331-5589. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty.
Southwest Maxillofacial Surgery & Implant Center can be contacted via phone (404) 629-6610, or through Gordon, Jacques Leonel via phone (404) 629-6610.
Contact Information
Primary practice address
3885 Princeton Lakes Way Sw 406
Atlanta GA 30331-5589
Phone: (404) 629-6610
Fax: (404) 629-6630
Website:
Authorized official contact:
Name: Gordon, Jacques Leonel Doctor of Dental Medicine (DMD)
Phone: (404) 629-6610
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DN013463 | Georgia |
Profile Details
| NPI number | 1073743795 |
|---|---|
| LBN Legal business name | Southwest Maxillofacial Surgery & Implant Center |
| DBA Doing business as | |
| Authorized official | Gordon, Jacques Leonel Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 15th, 2009 |
| Last updated | Jul 15th, 2009 - about 15 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073743795 | NPPES |
| Georgia | MEDICAID | 457061566A |
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