Organization · Type 2 NPI

Upstate Oral and Maxillofacial Surgery, P.a.

Oral and Maxillofacial Surgery (Dentist) · Spartanburg, SC

NPI number 1366577389 Active

Practice location

280 North Grove Medical Park Dr.
Spartanburg, SC 29303-4222

Fax (864) 585-4800

Mailing address

280 North Grove Medical Park Drive
Spartanburg, SC 29303-4222

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X2121 (SC)
Oral and Maxillofacial Surgery (Dentist) 1223S0112X2143 (SC)

Oral and Maxillofacial Surgery (Dentist): 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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About NPI 1366577389

Upstate Oral and Maxillofacial Surgery, P.a.'s National Provider Identifier is 1366577389, issued on Feb 22, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Spartanburg, SC. The record was last updated on Jan 6, 2011.