Organization
COASTAL ORAL MAXILLOFACIAL SURGERY & IMPLANTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN DANIEL KIELY DMD (OWNER/ORAL SURGEON)
(757) 207-0138
Entity
Organization
Contact information
Practice address
5408 DISCOVERY PARK BLVD, SUITE 101, WILLIAMSBURG, VA 23188-2893
(757) 208-0138
(757) 206-1981
Mailing address
5408 DISCOVERY PARK BLVD, SUITE 101, WILLIAMSBURG, VA 23188-2893
(757) 208-0138
(757) 206-1981
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401007303
VA
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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