ADVANCED ORAL AND MAXILLOFACIAL SURGERY PC
Medical Practice at Roswell Rd, Marietta, GA

License number
Georgia 053375
Category
Medical Practice
Type
Oral & Maxillofacial Surgery
Owner
Name: DR. DANIEL P BRUNNER SR. MD DDS
Title: PRESIDENT
Phone: (770) 321-0257
Address
Address
3535 Roswell Rd SUITE 27, Marietta, GA 30062
National Provider ID: 1952363442
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ADVANCED ORAL AND MAXILLOFACIAL SURGERY, PC

3535 Roswell Rd SUITE 27, Marietta, GA 30062

Registration:
Aug 11, 2003
State ID:
0344072
Business type:
Domestic Professional Corporation
CFOs:
M. Melissa Brunner (Secretary), 8 Colonial Clb Dr, Acworth, GA 30102 (Physical),Brunner P. (CFO), 8 Colonial Clb Dr, Acworth, GA 30102 (Physical)
Agent:
Daniel P Brunner M.d., D.d.s,8 Colonial Clb Dr, Marietta, GA (Physical)

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