Lakeside Oral Surgery, LLC

NPI #1225732472 in Eatonton, Georgia

Provider Information

NPI Number
1225732472
Entity Type
Organization
Organization Name
Lakeside Oral Surgery, LLC
Primary Specialty
Oral & Maxillofacial Surgery
Enumeration Date
Mar 29, 2023
Last Updated
Mar 29, 2023

Practice Location

Address
1097 LAKE OCONEE PKWY STE 101
State
Georgia
ZIP Code
31024-9510
Phone
(706) 916-4764

Authorized Official

Name
MRS. JENNIFER TOMLINSON
Title
CREDENTIALING SPECIALIST
Phone
(404) 410-1340

Specialties & Taxonomy Codes

Specialty
Oral & Maxillofacial Surgery

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