ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA; NPI #1629288824

Contact Information

ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA

1301 PLANTATION ISLAND DR S
SUITE 101
SAINT AUGUSTINE, FL 32080-3108

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

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NPI Profile & details for ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA

NPI # 1629288824

LBN Legal business name ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA

Authorized official DOUGLAS JOHNSON - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/23/2007

Last updated 06/23/2008 - About 18 years ago

Identifiers

FL	License #	DN15568
FL	Other	DD5857	RAILROAD MEDICARE GROUP

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA

Contact Information

Specialty

Oral & Maxillofacial Surgery

Oral and Maxillofacial Surgery

Plastic Surgery Within the Head and Neck

NPI Profile & details for ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA

Reviews for ST AUGUSTINE ORAL & FACIAL SURGICAL CENTER PA