OrganizationActive
Advanced Aesthetics, P.C
NPI 1144212846 · Plastic Surgery Physician · Fayetteville, GA
Provider details
- NPI number
- 1144212846
- Entity type
- Organization
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mary Snow, Precertification Coordinator(678) 883-1405
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
874 W Lanier Ave
One Prestige Park Suite 100
Fayetteville, GA 30214-1511
Phone: (770) 461-4000
Fax: (770) 461-2790
Approximate (ZIP-level) locationGet directions
Mailing address
874 W Lanier Ave
Fayetteville, GA 30214-1511
Registry dates
- Enumerated
- 2005-08-18
- Last updated
- 2007-08-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.