Organization
ORAL & MAXILLOFACIAL SURGERY ASSOCIATES OF CHARLESTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LON R DOLES DDS (PRESIDENT)
(843) 554-5003
Entity
Organization
Contact information
Practice address
2320 COSGROVE AVE, CHARLESTON, SC 29405-7644
(843) 554-5003
(843) 745-0003
Mailing address
2320 COSGROVE AVE, CHARLESTON, SC 29405-7644
(843) 554-5003
(843) 745-0003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9621
—
SC
Enumeration date
06/09/2006
Last updated
07/21/2022
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