Organization
AUGUSTA ORAL SURGERY SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL C D'ARCO DDS (OWNER)
(706) 228-3100
Entity
Organization
Contact information
Practice address
3736 WALTON WAY EXT, AUGUSTA, GA 30907-2402
(706) 228-3100
(706) 228-3707
Mailing address
3736 WALTON WAY EXT, AUGUSTA, GA 30907-2402
(706) 228-3100
(706) 228-3707
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN011130
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00707407B
—
GA
01
—
19NCCCT
MEDICARE ID
GA
Enumeration date
02/08/2008
Last updated
10/30/2012
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