National Provider Identifier Database

NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY PA
Oral and Maxillofacial Surgery

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.


Contact Information

NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, P.A.
4850 N 9TH AVE STE 1
PENSACOLA, FL32503-2407
Phone: 850-478-7070
Fax: 850-476-2513
Website:
Specialty Taxonomy Code
* Oral and Maxillofacial Surgery 261QS0112X
Oral and Maxillofacial Surgery 1223S0112X

* Indicates primary specialty

NPI Profile & details for NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, P.A.

NPI Number 1598069239
Legal business name
LBN
NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, P.A.
Authorized official BRETT LAGGAN - (ORAL & MAXILLOFACIAL SURGEON)
Entity Organization
Organization subpart No
Enumeration date 01/10/2011
Last updated 04/20/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • FL License #: DN18924
  • FL Medicaid: 073210900
  • FL Medicaid: 076708500

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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