Organization
GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI
Active
Parent organization
GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI
Other names
Summerville Oral Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREENVILLE ORAL MAXILLOFACIAL SURGERY, P.A., A SOUTH CAROLINA PROFESSI
Authorized official
TINA A HICKS (BILLING)
(864) 216-7924
Entity
Organization
Contact information
Practice address
403 W 4TH NORTH ST UNIT A, SUMMERVILLE, SC 29483-6552
(843) 821-7583
Mailing address
403 W 4TH NORTH ST UNIT A, SUMMERVILLE, SC 29483-6552
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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