| Cornerstone Oral And Maxillofacial Surgery | |
|
403 Cowart Ave Valdosta GA 31602-2635 | |
| (912) 408-7100 | |
| (912) 408-7101 |
| Full Name | Cornerstone Oral And Maxillofacial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 403 Cowart Ave, Valdosta, Georgia |
| Authorized Official Name and Position | Roger Myers (OWNER) |
| Authorized Official Contact | 9124320685 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cornerstone Oral And Maxillofacial Surgery Po Box 372 Pooler GA 31322-0372 Ph: (912) 432-0685 | Cornerstone Oral And Maxillofacial Surgery 403 Cowart Ave Valdosta GA 31602-2635 Ph: (912) 408-7100 |
| NPI Number | 1356983746 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 10/17/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356983746 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
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