Provider Demographics
NPI:1861594863
Name:METROPOLITAN ORAL SURGERY ASSOCIATES LLC
Entity type:Organization
Organization Name:METROPOLITAN ORAL SURGERY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:T
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MD
Authorized Official - Phone:404-874-1115
Mailing Address - Street 1:1175 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1202
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30361-6202
Mailing Address - Country:US
Mailing Address - Phone:404-874-1115
Mailing Address - Fax:404-874-0624
Practice Address - Street 1:1175 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1202
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30361-6202
Practice Address - Country:US
Practice Address - Phone:404-874-1115
Practice Address - Fax:404-874-0624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty