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Contact Information

ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA
1301 PLANTATION ISLAND DR S
SUITE 101
SAINT AUGUSTINE, FL32080-3108
 Phone: 904-460-0505
 Fax: 904-460-0506
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
 

Plastic Surgery Within the Head and Neck

2082S0099X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for ST AUGUSTINE ORAL FACIAL SURGICAL CENTER PA · (Female)

NPI # 1629288824
Status Active
Credentials
Entity Individual
Enumeration date 05/23/2007
Last updated 06/23/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # DN15568
  • FL Other DD5857 RAILROAD MEDICARE GROUP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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