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1000 Towne Center Blvd Ste 103 Pooler GA 31322-4052 | |
| (912) 354-1515 | |
| (912) 354-8181 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1000 Towne Center Blvd Ste 103, Pooler, Georgia |
| Authorized Official Name and Position | Michael C Wilson (OWNER) |
| Authorized Official Contact | 9123541515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
501 Eisenhower Dr Savannah GA 31406-2668 Ph: (912) 354-1515 | 1000 Towne Center Blvd Ste 103 Pooler GA 31322-4052 Ph: (912) 354-1515 |
| NPI Number | 1811640790 |
|---|---|
| Provider Enumeration Date | 01/31/2022 |
| Last Update Date | 10/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811640790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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