Organization
VAN METER ORAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JACKSON VAN METER III DMD, MD (ORAL SURGEON)
(601) 825-0021
Entity
Organization
Contact information
Practice address
300 MAXEY DR, BRANDON, MS 39042-2576
(601) 825-0021
(601) 825-0081
Mailing address
300 MAXEY DR, BRANDON, MS 39042-2576
(601) 825-0021
(601) 825-0081
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
OS-466-13
MS
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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