Southern Oral And Maxillofacial Surgery Center, Inc in Vicksburg - Oral And Maxillofacial Surgery
Southern Oral And Maxillofacial Surgery Center, Inc - NPI 1073784880
Southern Oral And Maxillofacial Surgery Center, Inc is a Oral And Maxillofacial Surgery in Vicksburg, Mississippi. Southern Oral And Maxillofacial Surgery Center, Inc practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Southern Oral And Maxillofacial Surgery Center, Inc is 1073784880. The last update date is 2008-03-19.
Southern Oral And Maxillofacial Surgery Center, Inc's current location address is 1205 Mission Park Dr, Vicksburg, Mississippi. You can contact this provider via phone number 6016610034 and fax number 6016610367. The mailing address for Southern Oral And Maxillofacial Surgery Center, Inc is 1205 Mission Park Dr, Vicksburg, Mississippi. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Southern Oral And Maxillofacial Surgery Center, Inc |
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Address | 1205 Mission Park Dr, Vicksburg, Mississippi |
Phone Number | 6016610034 |
Fax Number | 6016610367 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | SURGEON/OW |
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Authorized Official Name | Keen Keith Kevin |
Credentials | DMD |
Telephone Number | 6016610034 |
NPI Number Detail
NPI Number | 1073784880 |
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Provider Enumeration Date | 2008-03-19 |
Last Updated Date | 2008-03-19 |
Provider Mailing Address Detail
Address | 1205 Mission Park Dr |
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City | Vicksburg |
State | Mississippi (MS) |
Post Code | 391803747 |
Phone Number | 6016610034 |
Fax Number | 6016610367 |
Provider's Primary Taxonomy Detail
Speciality | Oral And Maxillofacial Surgery |
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Taxonomy | 1223S0112X |
Licence No | 2951-96 |
Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Post Comment/ Review Below
What is the unique identification code assigned to Southern Oral And Maxillofacial Surgery Center, Inc by the Centers for Medicare & Medicaid Services?
The Southern Oral And Maxillofacial Surgery Center, Inc has been issued the NPI (National Provider Identifier) 1073784880. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Southern Oral And Maxillofacial Surgery Center, Inc's facilities are geographically located?
The facilities of Southern Oral And Maxillofacial Surgery Center, Inc are physically situated at the following location: 1205 Mission Park Dr, Vicksburg, MS, 391803747.
What is the area of specialization for Southern Oral And Maxillofacial Surgery Center, Inc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Southern Oral And Maxillofacial Surgery Center, Inc is Oral And Maxillofacial Surgery, and the corresponding taxonomy code that categorizes this area of expertise is 1223S0112X.
On what date did Southern Oral And Maxillofacial Surgery Center, Inc receive its 1073784880 assignment from the Centers for Medicare & Medicaid Services?
The Southern Oral And Maxillofacial Surgery Center, Inc was assigned its 1073784880 on 2008-03-19, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Southern Oral And Maxillofacial Surgery Center, Inc last refreshed?
The information related to the Southern Oral And Maxillofacial Surgery Center, Inc, including its address, specialty, and other relevant details, was last updated on 2008-03-19.
NPI Number: 1457354839
Address: P.o. Box 1252, Spartanburg, SC