Central Georgia Oral And Maxillofacial Surgery, Llc

NPI 1023234853 - Dentist - 1223S0112X

NPI Details
NPI 1023234853
Enumeration Date 04/18/2007
Last Updated 10/01/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CLYDE D CLYDE
Position PRESIDENT
Phone (478) 745-0200
Fax
Practice Location
740 FIRST ST.
MACON GA, 31201-6840, US
Phone (478) 745-0200
Fax
Business Location
740 FIRST ST.
MACON GA, 31201-6840, US
Phone (478) 745-0200
Fax
Toxanomy
Taxonomy Code 1223S0112X
License State Georgia
License Number 6880
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According to our database, Central Georgia Oral And Maxillofacial Surgery, Llc NPI is 1023234853, taxonomy code is 1223S0112X and license number is 6880, license state is located at Georgia. Central Georgia Oral And Maxillofacial Surgery, Llc physically located at 740 First St., Macon GA, 31201-6840. NPI Number 1033115704 has the healthcare provider type.

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1023234853 NPI number is provided on an as is basis without warranty of any kind. 1023234853 is maintained by the National Plan & Provider Enumeration System. The contents of Central Georgia Oral And Maxillofacial Surgery, Llc are for informational purposes only.