Organization
EASTERN SHORE ORAL, FACIAL AND IMPLANT SURGERY CENTER, P.C.
Active
Organization
EASTERN SHORE ORAL, FACIAL AND IMPLANT SURGERY CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CORDERO DMD, MD (OWNER/ SURGEON)
(251) 333-1700
Entity
Organization
Contact information
Practice address
24172 4TH STREET, FAIRHOPE, AL 36532
(251) 333-1700
(251) 333-1701
Mailing address
24172 4TH STREET, FAIRHOPE, AL 36532
(251) 333-1700
(251) 333-1701
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
6357
AL
Other
Enumeration date
07/24/2017
Last updated
07/21/2022
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