COASTAL ORAL SURGERY ASSOCIATES NPI 1457735995

NPI Information

  • NPI: 1457735995
  • Provider Name: COASTAL ORAL SURGERY ASSOCIATES
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 110 OFFICE PARK LN
    SUITE 104
    SAINT SIMONS ISLAND, GA
    ZIP 31522
  • Phone: (912) 634-6600

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NPI Details

COASTAL ORAL SURGERY ASSOCIATES is an oral and maxillofacial surgery dentist in Saint Simons Island, GA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. COASTAL ORAL SURGERY ASSOCIATES NPI is 1457735995. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

110 OFFICE PARK LN
SUITE 104
SAINT SIMONS ISLAND, GA
ZIP 31522-601
Phone: (912) 634-6600
Fax: (912) 634-3882

The provider's authorized official is Jeffrey Oliver Capes .
The authorized official title is Owner and has the following contact phone number (912) 634-6600.

The enumeration date for this NPI number is 7/15/2015 and was last updated on 7/15/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery011515GEORGIAYes

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This page was last updated on: 11/21/2025

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