| Southwest Oral And Maxillofacial Surgery,llc | |
|
620 Pointe North Boulevard Albany GA 31721 | |
| (678) 350-6566 | |
| Not Available |
| Full Name | Southwest Oral And Maxillofacial Surgery,llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 620 Pointe North Boulevard, Albany, Georgia |
| Authorized Official Name and Position | Brad J Harris (SOLE MEMBER/ORAL SURGEON) |
| Authorized Official Contact | 6783506566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Oral And Maxillofacial Surgery,llc Po Box 4896 Canton GA 30114-0026 Ph: (678) 350-6566 | Southwest Oral And Maxillofacial Surgery,llc 620 Pointe North Boulevard Albany GA 31721 Ph: (678) 350-6566 |
| NPI Number | 1023347937 |
|---|---|
| Provider Enumeration Date | 12/24/2009 |
| Last Update Date | 12/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023347937 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DNO12915 (Georgia) | Primary |
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