Southwest Maxillofacial Surgery & Implant Center
Oral and Maxillofacial Dental Clinic
3885 Princeton Lakes Way Sw, 406, Atlanta
Georgia, 30331-5589
404-629-6610 404-629-6630
Maps & DirectionsSouthwest Maxillofacial Surgery & Implant Center is a Oral and Maxillofacial Dental Clinic in Atlanta, Georgia. It is located at 3885 Princeton Lakes Way Sw, 406, Atlanta, GA and its contact number is 404-629-6610. The authorized person for Southwest Maxillofacial Surgery & Implant Center is Dr. Jacques Leonel Gordon
who is President of the clinic and their contact number is 404-629-6610. The primary license number for Southwest Maxillofacial Surgery & Implant Center is DN013463 (Oral and Maxillofacial Surgery) in Georgia.
Southwest Maxillofacial Surgery & Implant Center Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
Southwest Maxillofacial Surgery & Implant Center Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Southwest Maxillofacial Surgery & Implant Center |
| Specialization: | Oral and Maxillofacial Surgery |
| Clinic Address: | 3885 Princeton Lakes Way Sw, 406, Atlanta,
Georgia, 30331-5589 |
| Phone: | 404-629-6610 |
| Fax: | 404-629-6630 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Jacques Leonel Gordon |
| Position: | President |
| Contact Number: | 404-629-6610 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Southwest Maxillofacial Surgery & Implant Center clinic are as mentioned below.
| NPI Number: | 1073743795 |
| NPI Enumeration Date: | 15 Jul, 2009 |
| NPI Last Update On: | 15 Jul, 2009 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southwest Maxillofacial Surgery & Implant Center are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral and Maxillofacial Surgery | DN013463 | Georgia | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 457061566A | Medicaid | Georgia | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Southwest Maxillofacial Surgery & Implant Center
3885 Princeton Lakes Way Sw, 406
Atlanta, Georgia |
| Zip: | 30331-5589 |
| Phone Number: | 404-629-6610 |
| Fax Number: | 404-629-6630 |
Patients can reach Southwest Maxillofacial Surgery & Implant Center at
3885 Princeton Lakes Way Sw, 406, Atlanta, Georgia or can
call to book an appointment on 404-629-6610.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.