Organization
SOUTH STRAND ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY E BARNES (OFFICE MANAGER)
(843) 527-2081
Entity
Organization
Contact information
Practice address
1729 N FRASER ST, GEORGETOWN, SC 29440-6407
(843) 527-2081
(843) 520-4821
Mailing address
1729 N FRASER ST, GEORGETOWN, SC 29440-6407
(843) 527-2081
(843) 520-4821
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2206
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9864
—
SC
Enumeration date
01/25/2007
Last updated
08/22/2020
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