Southeastern Oral and Maxillofacial Surgical Associates P.C.

Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Savannah, GA

NPI 1801920301 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1801920301
Entity type
Organization (NPI type 2)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
Legal business name
SOUTHEASTERN ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES P.C.
Practice address
4815 Paulsen St
Savannah, GA 31405-4418
Phone
(912) 352-2324
Fax
(912) 354-0935
NPI assigned
Mar 15, 2007
Organization subpart
No

Authorized official

Name
Ms. Elaine Lieupo Carter
Title
Administrator
Phone
(912) 352-2324

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

143 Canal St
Ste 300
Pooler, GA 31322
Phone (912) 330-8801

9390 Ford Ave
Ste 1
Richmond Hill, GA 31324
Phone (912) 756-7136

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X SINGLE SPECIALTY GROUP
1223S0112X GA
Oral and Maxillofacial Surgery (Dentist)
Group: 193200000X MULTI-SPECIALTY GROUP
1223S0112X Yes
Oral & Maxillofacial Surgery (D.M.D.)
Group: 193200000X MULTI-SPECIALTY GROUP
204E00000X

Addresses

Primary practice location

4815 Paulsen St
Savannah, GA 31405-4418

Mailing address

4815 Paulsen St
Savannah, GA 31405-4418
Phone (912) 352-2324

Other providers in Savannah, GA

All providers in Savannah, GA · Oral and Maxillofacial Surgery (Dentist) in Georgia

Sources for this page

Verify at the official NPI Registry.