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Organization
GOLDEN ISLES ORAL SURGERY, L.L.C.
Active
Organization
GOLDEN ISLES ORAL SURGERY, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER E. HALL D.M.D. (OWNER)
(912) 264-6420
Entity
Organization
Contact information
Practice address
17 PROFESSIONAL DRIVE, SUITE 100, BRUNSWICK, GA 31520-3794
(912) 264-6420
(912) 264-6242
Mailing address
17 PROFESSIONAL DRIVE, SUITE 100, BRUNSWICK, GA 31520-3794
(912) 264-6420
(912) 264-6242
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN011864
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
667957245C
—
GA
Enumeration date
09/11/2012
Last updated
10/15/2012
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