Coastal Oral Surgery Associates
Dentist, Oral and Maxillofacial Surgery in Saint Simons Island, GA. Organization (NPI-2).
NPI number1457735995
StatusActive
Last updated in NPPESJul 15, 2015
Details
- NPI
- 1457735995
- Entity type
- Organization (NPI-2)
- Legal business name
- Coastal Oral Surgery Associates
- Organization subpart
- No
- Enumeration date
- Jul 15, 2015
- Last updated
- Jul 15, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 011515 | GA | Yes |
Practice location
110 Office Park LnSuite 104
Saint Simons Island, GA 31522-6601
Phone 912-634-6600 · Fax 912-634-3882
Mailing address
110 Office Park LnSuite 104
Saint Simons Island, GA 31522-6601
Phone 912-634-6600 · Fax 912-634-3882
Authorized official
Jeffrey Oliver Capes
Owner
9126346600
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