Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Oconee Oral and Maxillofacial Surgery, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1154681195

Lake Oconee Oral and Maxillofacial Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Greensboro, Georgia. Licensed in Georgia. Registered with an NPI since 2012.

Licensed in
GA
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1031 Founders Row
Greensboro, GA 30642
Phone: (706) 454-1500
Fax: (706) 454-1501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence DN012341 (GA)

Record details

NPI number1154681195
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Miller — President · (706) 454-1500
NPI enumeratedMay 24, 2012
Last updated in NPPESJune 29, 2012
Mailing address1031 Founders Row, Greensboro, GA 30642

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