St Augustine Oral & Facial Surgical Center Pa

LBN: St Augustine Oral & Facial Surgical Center Pa
St Augustine Oral & Facial Surgical Center Pa is an health care organization with primary practice located at 1301 Plantation Island Dr S Suite 101, St Augustine FL 32080-3108. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is the primary health care specialty. St Augustine Oral & Facial Surgical Center Pa can be contacted via phone (904) 460-0505, or through Johnson, Douglas L via phone (904) 460-0505.

Contact Information

Primary practice address
1301 Plantation Island Dr S Suite 101 St Augustine FL 32080-3108
Phone: (904) 460-0505
Fax: (904) 460-0506
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Douglas L Doctor of Dental Surgery (DDS)
Phone: (904) 460-0505

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN15568 Florida
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X DN15568 Florida
Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck 2082S0099X DN15568 Florida

Profile Details

NPI number 1629288824
LBN Legal business name St Augustine Oral & Facial Surgical Center Pa
DBA Doing business as
Authorized official Johnson, Douglas L Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2007
Last updated Jun 23rd, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629288824 NPPES
Florida Other DD5857 RAILROAD MEDICARE GROUP

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