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Organization
STATESBORO ORAL AND MAXILLOFACIAL SURGERY, INC.
Active
Organization
STATESBORO ORAL AND MAXILLOFACIAL SURGERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY M LAWHORN DMD (PRESIDENT)
(912) 764-4495
Entity
Organization
Contact information
Practice address
4463 COUNTRY CLUB RD, STATESBORO, GA 30458-9188
(912) 764-4495
(912) 764-3650
Mailing address
4463 COUNTRY CLUB RD, STATESBORO, GA 30458-9188
(912) 764-4495
(912) 764-3650
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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