Organization
GEORGIA DENTAL AFFILIATES, LLC
Active
Other names
Coastal Oral Surgery Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY CAPES DMD (MANAGING DENTIST)
(912) 634-6600
Entity
Organization
Contact information
Practice address
110 OFFICE PARK LN STE 104, ST SIMONS ISLAND, GA 31522-6604
(912) 634-6600
Mailing address
110 OFFICE PARK LN STE 104, ST SIMONS ISLAND, GA 31522-6604
(912) 634-6600
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/11/2023
Last updated
01/19/2024
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