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
| 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 |