ADVANCED ORAL AND MAXILLOFACIAL SURGERY PC (NPI# 1952363442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952363442 |
| Entity Type | Organization |
| Organization Name | ADVANCED ORAL AND MAXILLOFACIAL SURGERY PC |
| Other Organization Name | EAST COBB ORAL SURGERY |
| Practice Address |
3535 Roswell Rd Suite 27 Marietta GA 30062-8826 |
| Practice Telephone | 7703210257 |
| Practice Fax Number | 7703210346 |
| Mailing Telephone | 7703210257 |
| Mailing Fax Number | 7703210346 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2016-03-16 |
| Authorized Official Name | DR. DANIEL P BRUNNER SR. (PRESIDENT) |
| Authorized Official Telephone | 7703210257 |
| Authorized Official Credential | MD DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 053375 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| East Cobb Oral Surgery | Doing Business As Name - Organization |
| Street Address |
3535 ROSWELL RD SUITE 27 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-8826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952750309 | Kiran Bandali | Optometrist | 3535 Roswell Rd, Ste 8, Marietta, GA 30062-8826 | 2016-06-07 |
| 1750654141 | Map Eyes LLC | Optometrist | 3535 Roswell Rd, Suite 8, Marietta, GA 30062-8826 | 2012-02-15 |
| 1124300629 | Keiko Sweigart | Massage Therapist | 3535 Roswell Rd, Suite 23, Marietta, GA 30062-8826 | 2011-09-12 |
| 1457672958 | Daniel Paul Brunner | Dentist | 3535 Roswell Rd, Suite 27, Marietta, GA 30062-8826 | 2010-06-18 |
| 1043470883 | Digital Radiographic Diagnostics, LLC | Clinic/Center | 3535 Roswell Rd, Suite-1 Building-1, Marietta, GA 30062-8826 | 2008-06-16 |
| 1073795746 | The Widen Clinic | Chiropractor | 3535 Roswell Rd, Ste. 37, Marietta, GA 30062-8826 | 2007-12-04 |
| 1104045251 | Woodlawn Medical Group of Arizona | Radiologic Technologist | 3535 Roswell Rd, Suite 20, Marietta, GA 30062-8826 | 2007-04-25 |
| 1205053188 | Hank Bradford | Dentist | 3535 Roswell Rd, Suite 46, Marietta, GA 30062-8826 | 2007-04-20 |
| 1700947132 | Denise Angella Hall | Dentist | 3535 Roswell Rd, Suite 14, Marietta, GA 30062-8826 | 2006-12-12 |
| 1922168046 | John E Schad | Chiropractor | 3535 Roswell Rd, Suite 6, Marietta, GA 30062-8826 | 2006-12-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124203286 | Brad Jason Harris | Oral & Maxillofacial Surgery | 55 Whitcher St Ne, Suite 140, Marietta, GA 30060-1155 | 2008-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124453337 | Ladi Doonquah | Oral & Maxillofacial Surgery | 3660 Flat Shoals Rd Ste 100, Decatur, GA 30034-1649 | 2013-09-06 |
| 1699040121 | Shenan Marie Bradshaw | Oral & Maxillofacial Surgery | 5505 Peachtree Dunwoody Rd Ste 660, Sandy Springs, GA 30342 | 2012-03-16 |
| 1720107105 | Christian Loetscher | Oral & Maxillofacial Surgery | 4205 N Point Pkwy Ste F, Alpharetta, GA 30022-8808 | 2007-03-28 |
| 1659460772 | William Jones Phillips | Oral & Maxillofacial Surgery | 698 Medical Park Lane, Gainesville, GA 30501 | 2006-10-12 |
| 1841306909 | Lawrence Matthew Marra | Oral & Maxillofacial Surgery | 3965 Holcomb Bridge Road, Suite 102, Norcross, GA 30092 | 2006-08-22 |
| 1861505141 | Durwood M Johnson Jr. | Oral & Maxillofacial Surgery | 1260 Hwy 54 W, Suite 200, Fayetteville, GA 30214 | 2006-08-17 |
| 1184667370 | Scott S Derossi | Oral & Maxillofacial Surgery | 1430 John Wesley Gilbert Drive, Gc-1024, Ghsu College of Dental Medicine, Augusta, GA 30912-1001 | 2006-06-14 |
| 1942258397 | Henry W Ferguson | Oral & Maxillofacial Surgery | 1430 John Wesely Gilbert Drive, Gc-1024, Augusta, GA 30912-1001 | 2006-05-05 |
| 1295791549 | Glenn Maron | Oral & Maxillofacial Surgery | 999 Peachtree St Ne, Ste 715, Atlanta, GA 30309 | 2006-04-25 |
| 1114425964 | Gofs Stockbridge | Oral & Maxillofacial Surgery | 225 Country Club Dr, #110, Stockbridge, GA 30281 | 2018-01-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.