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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