# CHARLESTON JAW SURGERY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SHELBOURNE & ASSOCIATES ORAL & FACIAL SURGERY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437763661
- **Legal business name:** SHELBOURNE & ASSOCIATES ORAL & FACIAL SURGERY
- **Authorized official:** ROBERT BENNETT (BUSINESS MANAGER)
- **Authorized official phone:** (843) 853-5859

## Contact information

- **Practice address:** 846 ST. ANDREWS BLVD., CHARLESTON, SC 29407
- **Practice address phone:** (843) 853-5859
- **Practice address fax:** (843) 853-5861
- **Mailing address:** 846 ST. ANDREWS BLVD., CHARLESTON, SC 29407
- **Mailing address phone:** (843) 853-5859
- **Mailing address fax:** (843) 853-5861

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 09/04/2020
- **Last updated:** 09/04/2020