| Central Georgia Oral And Maxillofacial Surgery, Llc | |
|
740 First St. Macon GA 31201-6840 | |
| (478) 745-0200 | |
| Not Available |
| Full Name | Central Georgia Oral And Maxillofacial Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 740 First St., Macon, Georgia |
| Authorized Official Name and Position | Clyde D Marlow (PRESIDENT) |
| Authorized Official Contact | 4787450200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Georgia Oral And Maxillofacial Surgery, Llc 740 First St. Macon GA 31201-6840 Ph: (478) 745-0200 | Central Georgia Oral And Maxillofacial Surgery, Llc 740 First St. Macon GA 31201-6840 Ph: (478) 745-0200 |
| NPI Number | 1023234853 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 10/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023234853 | NPI | - | NPPES |
| 6880 | Other | GA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 6880 (Georgia) | Primary |
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