Valdosta Oral And Maxillofacial Surgeons | |
2720 N Oak St Valdosta GA 31602-1781 | |
(229) 247-5590 | |
(229) 241-0698 |
Full Name | Valdosta Oral And Maxillofacial Surgeons |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 2720 N Oak St, Valdosta, Georgia |
Authorized Official Name and Position | Janice Martin (ADMINISTRATIVE ASSISTANT) |
Authorized Official Contact | 2292475590 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Valdosta Oral And Maxillofacial Surgeons 2720 N Oak St Valdosta GA 31602-1781 Ph: (229) 247-5590 | Valdosta Oral And Maxillofacial Surgeons 2720 N Oak St Valdosta GA 31602-1781 Ph: (229) 247-5590 |
NPI Number | 1912173022 |
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Provider Enumeration Date | 05/08/2008 |
Last Update Date | 05/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912173022 | NPI | - | NPPES |
GRP6639 | Other | GA | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN008219 (Georgia) | Primary |
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