Wednesday, August 10, 2022

ALEXANDER T GEDEVANISHVILI , M.D. in LAGRANGE – NPI – 1578558714

ALEXANDER T GEDEVANISHVILI , M.D. in LAGRANGE - NPI - 1578558714

ALEXANDER T GEDEVANISHVILI is a dentist based out of MARIETTA,Georgia ALEXANDER practices in LAGRANGE,Georgia and has the professional credentials of M.D. .The NPI Number for ALEXANDER T GEDEVANISHVILI is 1578558714 and he holds a Licence No. 54099(Georgia).

ALEXANDER current practice location address is 805 SANDY PLAINS ROAD,MEDICAL STAFF SERVICES,MARIETTA,Georgia and he can be reached out via phone at 7062425100 and via fax at7068122454. You can also correspond with ALEXANDER T GEDEVANISHVILI through mail at his mailing address at1602 VERNON RD STE 300,,LAGRANGE,Georgia – 30240 (mailing address contact number – 300666340).

Provider Profile Details

Credential
NPI Number 1578558714
Provider Name ALEXANDER T GEDEVANISHVILI
M.D.
Gender 43774
Provider Entity Type Individual
Provider Enumeration Date 207RC0000X
Last Update Date 38609

Provider Business Mailing Address Details

Address 805 SANDY PLAINS ROAD,MEDICAL STAFF SERVICES
City MARIETTA
State Georgia
Zip 300666340
Phone Number

Provider Business Practice Location Address Details

Address 1602 VERNON RD STE 300,
City LAGRANGE
State Georgia
Zip 30240
Phone Number 7062425100

Provider's Primary Taxonomy Details

Taxonomy 207RC0000X
License No. 54099
State Georgia

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