| NPI | 1225543515 |
|---|---|
| Doing Business As | ORAL & FACIAL SURGERY OF WEST GEORGIA |
| Entity Type | Organization |
| Authorized Contact | THOMAS H FUQUA Managing Member 334-749-3436 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: AL MD28533) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |