| NPI | 1649843301 |
|---|---|
| Doing Business As | OMS OF COASTAL GA |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS THEODOTOU Oral Surgeon 912-600-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2021-07-21 |
| Last Update Date | 2021-07-21 |