Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southwest Maxillofacial Surgery & Implant Center

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1073743795

Southwest Maxillofacial Surgery & Implant Center is an Oral and Maxillofacial Surgery (Dentist) in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2009.

Licensed in
GA
In the registry since
2009

Practice location Address checks out

3885 Princeton Lakes Way SW 406
Atlanta, GA 30331-5589
Phone: (404) 629-6610
Fax: (404) 629-6630
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DN013463 (GA)

Record details

NPI number1073743795
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacques Gordon — President · (404) 629-6610
NPI enumeratedJuly 15, 2009
Last updated in NPPESJuly 15, 2009
Mailing address3885 Princeton Lakes Way Sw, 406, Atlanta, GA 30331-5589

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