Advanced Oral and Maxillofacial Surgery PC

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

053375 Issued in GA

Legal business name

ADVANCED ORAL AND MAXILLOFACIAL SURGERY PC

Doing business as

East Cobb Oral Surgery

Practice address

3535 Roswell Rd
Suite 27
Marietta, GA 30062-8826

Phone

(770) 321-0257

Fax

(770) 321-0346

NPI assigned

Apr 3, 2006

Last updated

Mar 16, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Daniel P Brunner Sr., MD DDSNPI 1457672958

Title

President

Phone

(770) 321-0257

Specialties & licenses 1

Addresses

Other names 1

• East Cobb Oral Surgery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Paul Brunner, M.D., D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Marietta, GA
  • NPI 1457672958
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1952363442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 ROSWELL RD",
            "address_2": "SUITE 27",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628826",
            "telephone_number": "770-321-0257",
            "fax_number": "770-321-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 ROSWELL RD",
            "address_2": "SUITE 27",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300628826",
            "telephone_number": "770-321-0257",
            "fax_number": "770-321-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ORAL AND MAXILLOFACIAL SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "BRUNNER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-321-0257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "GA",
            "license": "053375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Cobb Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral & Maxillofacial Surgery (D.M.D.) in Marietta, GA
• Providers in Marietta, GA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.