| Golden Isles Oral Surgery, L.l.c. | |
|
17 Professional Drive Suite 100 Brunswick GA 31520-3794 | |
| (912) 264-6420 | |
| (912) 264-6242 |
| Full Name | Golden Isles Oral Surgery, L.l.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 17 Professional Drive, Brunswick, Georgia |
| Authorized Official Name and Position | Jennifer E. Hall (OWNER) |
| Authorized Official Contact | 9122646420 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Isles Oral Surgery, L.l.c. 17 Professional Drive Suite 100 Brunswick GA 31520-3794 Ph: (912) 264-6420 | Golden Isles Oral Surgery, L.l.c. 17 Professional Drive Suite 100 Brunswick GA 31520-3794 Ph: (912) 264-6420 |
| NPI Number | 1205186863 |
|---|---|
| Provider Enumeration Date | 09/11/2012 |
| Last Update Date | 10/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205186863 | NPI | - | NPPES |
| 667957245C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN011864 (Georgia) | Primary |
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