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Berkeley Oral And Maxillofacial Surgery Pa
Oral and Maxillofacial Surgery (Dentist) in Bonneau, South Carolina
NPI 1558486845

Berkeley Oral And Maxillofacial Surgery Pa is a Oral and Maxillofacial Surgery (Dentist) based in Bonneau, SC and is specialized in Oral and Maxillofacial Surgery. Berkeley Oral And Maxillofacial Surgery Pa practices in Bonneau, SC. The NPI Number for Berkeley Oral And Maxillofacial Surgery Pa is 1558486845 and holds a License No. 3180 (South Carolina).

The current practice location address for Berkeley Oral And Maxillofacial Surgery Pa is 111 Shelly St., Bonneau, SC and can be reached out via phone at 843-825-4131 and via fax at 843-825-4136.

Location: 111 Shelly St., Bonneau, SC, 29431-0280
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1558486845
Provider Name
Berkeley Oral And Maxillofacial Surgery Pa
Credential
Provider Entity Type
Organization
Address
111 Shelly St., Bonneau, SC, 29431-0280
Phone Number
843-825-4131
Fax Number
843-825-4136
Provider Enumeration Date
03/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1790759967 01 SC INDIVIDUAL NPI
institution
Provider Business Practice Location Address Details
Address
111 Shelly St.
City
Bonneau
State
South Carolina
Zip
29431-0280
Phone Number
843-825-4131
Fax Number
843-825-4136
person
Provider Business Mailing Address Details
Address
111 Shelly St.
City
Bonneau
State
South Carolina
Zip
29431-0280
Phone Number
843-825-4131
Fax Number
843-825-4136
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
3180 (South Carolina)
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.
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