Provider Demographics
NPI:1366592636
Name:ORAL SURGERY ASSOCIATES OF CENTRAL GEORGIA
Entity type:Organization
Organization Name:ORAL SURGERY ASSOCIATES OF CENTRAL GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMAS
Authorized Official - Middle Name:KALMAN
Authorized Official - Last Name:SZAKAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:478-971-8811
Mailing Address - Street 1:324 MARGIE DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7817
Mailing Address - Country:US
Mailing Address - Phone:478-971-8811
Mailing Address - Fax:478-971-4591
Practice Address - Street 1:324 MARGIE DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7817
Practice Address - Country:US
Practice Address - Phone:478-971-8811
Practice Address - Fax:478-971-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA117251223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty