Organization
CAMDEN ORAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE M PENNINGTON M.D. (PRESIDENT)
(912) 673-6545
Entity
Organization
Contact information
Practice address
73 HAWTHORN LN, SAINT MARYS, GA 31558-4026
(912) 673-6545
(912) 576-1846
Mailing address
73 HAWTHORN LN, SAINT MARYS, GA 31558-4026
(912) 673-6545
(912) 576-1846
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN011196
GA
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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