# MH ORAL SURGERY LLC

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

## Provider details

- **NPI number:** 1679814578
- **Authorized official:** CRYSTAL WALKER (CREDENTIALING/FINANCIAL)
- **Authorized official phone:** (770) 420-8462

## Contact information

- **Practice address:** 1030 W GORDON AVE STE A, ALBANY, GA 31701-4515
- **Practice address phone:** (229) 432-9555
- **Mailing address:** 125 TOWNPARK DR NW, SUITE 300, KENNESAW, GA 30144-5803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 03/04/2013
- **Last updated:** 03/04/2013