# SMILE CENTER ORAL & MAXILLOFACIAL SURGERY, LLC

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

## Provider details

- **NPI number:** 1467345942
- **Authorized official:** WENDY DAVIS (CLAIMS ADMINISTRATOR)
- **Authorized official phone:** (229) 241-1010

## Contact information

- **Practice address:** 700 WILDWOOD PLANTATION DR, VALDOSTA, GA 31602-3606
- **Practice address phone:** (229) 241-1010
- **Practice address fax:** (507) 428-6342
- **Mailing address:** 700 WILDWOOD PLANTATION DR, VALDOSTA, GA 31602-3606
- **Mailing address phone:** (229) 241-1010
- **Mailing address fax:** (507) 428-6342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | NULL | Yes |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/02/2025
- **Last updated:** 06/02/2025