Organization
CORNERSTONE ORAL AND MAXILLOFACIAL SURGERY
Active
Other names
Corenerstone Oral And Maxillofacial surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER MYERS DMD (OWNER)
(912) 432-0685
Entity
Organization
Contact information
Practice address
403 COWART AVE, VALDOSTA, GA 31602-2635
(912) 408-7100
(912) 408-7101
Mailing address
PO BOX 372, POOLER, GA 31322-0372
(912) 432-0685
(912) 408-7101
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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