Organization
MCDONALD ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS ALBERT MCDONALD DMD, MD (OWNER)
(843) 799-4878
Entity
Organization
Contact information
Practice address
1509 HERITAGE LN, FLORENCE, SC 29505-3141
(843) 799-4878
(843) 799-4977
Mailing address
1509 HERITAGE LN, FLORENCE, SC 29505-3141
(843) 799-4878
(843) 799-4977
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3176
SC
Other
Enumeration date
03/12/2015
Last updated
01/25/2017
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