Provider Demographics
NPI:1164990164
Name:CAMDEN ORAL SURGERY & IMPLANT CENTER
Entity Type:Organization
Organization Name:CAMDEN ORAL SURGERY & IMPLANT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-699-5900
Mailing Address - Street 1:207 E. DEKALB ST.
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020
Mailing Address - Country:US
Mailing Address - Phone:803-398-9900
Mailing Address - Fax:803-398-9898
Practice Address - Street 1:207 E. DEKALB ST.
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020
Practice Address - Country:US
Practice Address - Phone:803-398-9900
Practice Address - Fax:803-398-9898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHEAST ORAL & MAXILLOFACIAL SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty