Organization
ORAL SURGERY GROUP OF COASTAL GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN JAMES CFO (CFO)
(502) 254-8500
Entity
Organization
Contact information
Practice address
506 US HIGHWAY 80 W, POOLER, GA 31322
(912) 330-9229
(912) 330-9220
Mailing address
506 US HIGHWAY 80 W, POOLER, GA 31322-2104
(912) 330-9229
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN013242
GA
Other
Enumeration date
03/27/2007
Last updated
08/24/2018
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