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General NPI Number Information
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NPI Number | 1346310505
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Entity Type | Organization
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Legal Business Name | ASSOCIATED ORAL & MAXILLOFACIAL SURGEONS, PC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 1007 SUSHRUTA DRIVE
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City | MARTINSBURG
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State | WV
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Zip | 25401
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Country | US
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Telephone | 304-263-0991
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Fax | 304-274-9546
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Provider Business Mailing Address
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Address Line | 1007 SUSHRUTA DRIVE
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City | MARTINSBURG
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State | WV
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Zip | 25401
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Country | US
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Telephone | 304-263-0991
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Fax | 304-274-9546
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PAMELA PHILLIPS
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Credential |
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Telephone | 304-263-0991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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