# SOUTHEASTERN ORAL & MAXILLOFACIAL SURGEONS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225115470
- **Authorized official:** DR. JOHN F COYNE DMD (PRESIDENT)
- **Authorized official phone:** (508) 588-0200

## Contact information

- **Practice address:** 951 NORTH MAIN STREET, BROCKTON, MA 02301
- **Practice address phone:** (508) 588-0200
- **Practice address fax:** (508) 583-6156
- **Mailing address:** 951 NORTH MAIN STREET, BROCKTON, MA 02301
- **Mailing address phone:** (508) 588-0200
- **Mailing address fax:** (508) 583-6156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 18127 | MA | Yes |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 08/22/2020