Organization
SMYRNA ORAL AND MAXILLOFACIAL SURGERY AND IMPLANTOLOGY CENTER, LLC
Active
Other names
Symrna OMS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CECIL PHILLIP STANCIL JR. D.D.S. (CEO)
(615) 207-1932
Entity
Organization
Contact information
Practice address
4849 S COBB DR SE, UNIT 200, SMYRNA, GA 30080-7145
(615) 207-1932
Mailing address
250 PARK AVENUE WEST NW, UNIT 204, ATLANTA, GA 30313-1603
(615) 207-1932
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN013667
GA
Other
Enumeration date
05/23/2010
Last updated
05/23/2010
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