| NPI | 1043409063 |
|---|---|
| Former Legal Business Name | CHARLESTON CENTER FOR ORAL & FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | JACKIE HOLLOWAY Director Of Rcm 854-200-7970 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SC 4006) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2025-11-24 |