# VAN METER ORAL SURGERY, LLC

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

## Provider details

- **NPI number:** 1851725816
- **Authorized official:** DR. CHARLES JACKSON VAN METER III DMD, MD (ORAL SURGEON)
- **Authorized official phone:** (601) 825-0021

## Contact information

- **Practice address:** 300 MAXEY DR, BRANDON, MS 39042-2576
- **Practice address phone:** (601) 825-0021
- **Practice address fax:** (601) 825-0081
- **Mailing address:** 300 MAXEY DR, BRANDON, MS 39042-2576
- **Mailing address phone:** (601) 825-0021
- **Mailing address fax:** (601) 825-0081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | OS-466-13 | MS | Yes |

## Other

- **Enumeration date:** 08/27/2013
- **Last updated:** 08/27/2013