Alfred E Pesto Jr. (NPI# 1295875755, PAC ID# 9133314370) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORAL SURGERY.
| Nation Provider ID (NPI) | 1295875755 |
| PAC ID by PECOS | 9133314370 |
| Professional Enrollment ID | I20101112000643 |
| Full Name | Alfred E Pesto Jr. |
| Organization Legal Name | SOUTHEASTERN ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES P.C. |
| Address |
143 Canal St Suite 300 Pooler GA 31322-6008 |
| Phone Number | 9123308801 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA SCHOOL OF DENTISTRY |
| Graduation Year | 1990 |
| Primary Specialty | ORAL SURGERY |
| Secondary Specialties | MAXILLOFACIAL SURGERY |
| Group Practice PAC ID | 5092774729 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110036 | MEMORIAL UNIVERSITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 143 Canal St, Suite 300, Pooler, GA 31322-6008 | 9123308801 | SOUTHEASTERN ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES P.C. |
| 4815 Paulsen St, Savannah, GA 31405-4418 | 9123522324 | SOUTHEASTERN ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES P.C. |
| Organization Legal Name | SOUTHEASTERN ORAL AND MAXILLOFACIAL SURGICAL ASSOCIATES P.C. |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William Massey | Maxillofacial Surgery | Southeastern Oral and Maxillofacial Surgical Associates P.C. | 4815 Paulsen St, Savannah, GA 31405-4418 |
| Justin B Damron | Oral Surgery | Southeastern Oral and Maxillofacial Surgical Associates P.C. | 143 Canal St, Suite 300, Pooler, GA 31322-6008 |
| Street Address |
143 CANAL ST SUITE 300 |
| City | POOLER |
| State | GA |
| Zip | 31322-6008 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michele Renee Henson | Allergy/immunology | 143 Canal St, Suite 200, Pooler, GA 31322-6014 | |
| Justin B Damron | Oral Surgery | Southeastern Oral and Maxillofacial Surgical Associates P.C. | 143 Canal St, Suite 300, Pooler, GA 31322-6008 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eric William Spreeman | Occupational Therapy | Tattnall Hospital Company LLC | 101 W Mulberry Blvd, Suite 140, Pooler, GA 31322 |
| Wayne Depaz | Chiropractic | 1017 Us Hwy 80 E 17, Pooler, GA 31322 | |
| Dawn Hostetter Macmillan | Qualified Audiologist | 410s W Hwy 80, Pooler, GA 31322 | |
| Nicholas Theodotou | Oral Surgery | 506 Us Hwy 80 W, Pooler, GA 31322-2104 | |
| Preston L Peacock | Chiropractic | 408 Us Hwy 80 Sw, Pooler, GA 31322-2541 | |
| Thomas Henry Bombery | Chiropractic | 122 Canal St, Suite 109, Pooler, GA 31322-4015 | |
| Thomas F Danello | Emergency Medicine | St Josephs Candler Urgent Care Centers LLC | 107 Canal St, Pooler, GA 31322-4016 |
| Patricia B Butler | Nurse Practitioner | St Josephs Candler Urgent Care Centers LLC | 107 Canal St, Pooler, GA 31322-4016 |
| Janet D Ohara | Nurse Practitioner | St Josephs Candler Urgent Care Centers LLC | 107 Canal St, Pooler, GA 31322-4016 |
| Angela C Wooley | Nurse Practitioner | St Josephs Candler Urgent Care Centers LLC | 107 Canal St, Pooler, GA 31322-4016 |
| Find all physicians in zip 31322 | |||
| City | POOLER |
| Zip Code | 31322 |
| Specialty | ORAL SURGERY |
| City + Specialty | POOLER + ORAL SURGERY |
Please comment or provide details below to improve the information on Alfred E Pesto Jr..
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.