# PORT ROYAL ORAL SURGERY PA

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

## Provider details

- **NPI number:** 1437365996
- **Authorized official:** DR. SIMONS HANE JR. DMD (CHAIRMAN)
- **Authorized official phone:** (843) 729-5409

## Contact information

- **Practice address:** 14 MARSHELLEN DR \# B, BEAUFORT, SC 29902-6900
- **Practice address phone:** (834) 729-5409
- **Mailing address:** 14 MARSHELLEN DR \# B, BEAUFORT, SC 29902-6900
- **Mailing address phone:** (843) 729-5409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 03964 | SC | Yes |

## Other

- **Enumeration date:** 05/14/2007
- **Last updated:** 08/22/2020