Organization
BULLOCH ORAL AND MAXILLOFACIAL SURGERY AND DENTAL IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER LEE MYERS D.M.D. (OWNER)
(912) 408-7100
Entity
Organization
Contact information
Practice address
301 FLORENCE AVE, STATESBORO, GA 30458-5138
(912) 408-7100
Mailing address
301 FLORENCE AVENUE, STATESBORO, GA 30458
(912) 408-7100
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN013413
GA
Other
Enumeration date
11/09/2009
Last updated
11/09/2009
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