Organization
SOUTHEASTERN ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELAINE LIEUPO CARTER (ADMINISTRATOR)
(912) 352-2324
Entity
Organization
Contact information
Practice address
4815 PAULSEN ST, SAVANNAH, GA 31405-4418
(912) 352-2324
(912) 354-0935
Mailing address
4815 PAULSEN ST, SAVANNAH, GA 31405-4418
(912) 352-2324
(912) 354-0935
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
GA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
Other
Enumeration date
03/15/2007
Last updated
07/21/2022
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