NPI 1225732472

Lakeside Oral Surgery, LLC

Organisation Oral & Maxillofacial Surgery (D.M.D.) Eatonton, GA

Practice location

Address: 1097 Lake Oconee Pkwy STE 101, Eatonton, GA 31024-9510
Phone: (706) 916-4764

Authorised official

Name: Jennifer Tomlinson
Title: Credentialing Specialist
Phone: (404) 410-1340

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X

Other Oral & Maxillofacial Surgery providers in Georgia →

Registry record

NPI: 1225732472
Entity type: Organization
NPI issued: 29 Mar 2023
Record last updated: 29 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.