Provider Demographics
NPI:1205219672
Name:PERIMETER FACIAL SURGEONS, LLC
Entity Type:Organization
Organization Name:PERIMETER FACIAL SURGEONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OMFS
Authorized Official - Prefix:DR
Authorized Official - First Name:PIYUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-559-3648
Mailing Address - Street 1:1505 MOUNT VERNON RD
Mailing Address - Street 2:# 150
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4157
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1505 MOUNT VERNON RD
Practice Address - Street 2:# 150
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4157
Practice Address - Country:US
Practice Address - Phone:770-559-3648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-03
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA117721223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty