# UPSTATE ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, P.A.

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

## Provider details

- **NPI number:** 1770707887
- **Authorized official:** DR. SAMER ATALLAH JOUDEH D.M.D. (OWNER)
- **Authorized official phone:** (864) 855-0383

## Contact information

- **Practice address:** 227 S PENDLETON ST, SUITE A, EASLEY, SC 29640-3047
- **Practice address phone:** (864) 855-0383
- **Practice address fax:** (864) 855-0390
- **Mailing address:** 227 S PENDLETON ST, SUITE A, EASLEY, SC 29640-3047
- **Mailing address phone:** (864) 855-0383
- **Mailing address fax:** (864) 855-0390

## Taxonomy

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

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020