| Coastal Maxillofacial Group | |
|
201 N College Dr 202 Santa Maria CA 93454-4614 | |
| (805) 928-7611 | |
| (805) 349-8551 |
| Full Name | Coastal Maxillofacial Group |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 201 N College Dr, Santa Maria, California |
| Authorized Official Name and Position | Marshall Sheridan Humes (PRESIDENT) |
| Authorized Official Contact | 8059287611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Maxillofacial Group 201 N College Drive Suite 202 Santa Maria CA 93454 Ph: (805) 928-7611 | Coastal Maxillofacial Group 201 N College Dr 202 Santa Maria CA 93454-4614 Ph: (805) 928-7611 |
| NPI Number | 1104979707 |
|---|---|
| Provider Enumeration Date | 01/19/2007 |
| Last Update Date | 07/17/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104979707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 27297 (California) | Primary |
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