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General NPI Number Information
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NPI Number | 1972718898
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Entity Type | Organization
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Legal Business Name | ORAL AND MAXILLOFACIAL SURGERY ASSOC.PA
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 1325 DRAYTON RD
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City | SPARTANBURG
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State | SC
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Zip | 29307-5106
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Country | US
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Telephone | 864-591-3500
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Fax | 864-591-2235
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Provider Business Mailing Address
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Address Line | 1325 DRAYTON RD
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City | SPARTANBURG
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State | SC
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Zip | 29307-5106
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Country | US
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Telephone | 864-591-3500
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Fax | 864-591-2235
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Authorized Official
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Title or Position | ORAL SURGEON
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Name | DR. CHARLES KEITH COX
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Credential | DDS
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Telephone | 864-591-3500
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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 | 3039
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License Number State | SC
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