# CAROLINA OMS ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SURFSIDE IMPLANT & ORAL SURGERY CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104134899
- **Authorized official:** KRISTIN E HUDSON (CONSULTANT)
- **Authorized official phone:** (910) 793-9545

## Contact information

- **Practice address:** 1003 OLDE WATERFORD WAY STE 1A, LELAND, NC 28451-4168
- **Practice address phone:** (910) 793-9545
- **Practice address fax:** (910) 397-0366
- **Mailing address:** PO BOX 15349, WILMINGTON, NC 28408-5349
- **Mailing address phone:** (910) 793-9545
- **Mailing address fax:** (910) 397-0366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 8366 | NC | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 8366 | NC | Yes |

## Other

- **Enumeration date:** 09/16/2010
- **Last updated:** 09/16/2010