Advanced Maxillofacial Surgical Llc | |
1895 Kingsley Ave Suite 403 Orange Park FL 32073-4466 | |
(904) 444-1578 | |
Not Available |
Full Name | Advanced Maxillofacial Surgical Llc |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 1895 Kingsley Ave, Orange Park, Florida |
Authorized Official Name and Position | Jason Lee (OWNER) |
Authorized Official Contact | 9044441578 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Advanced Maxillofacial Surgical Llc Po Box 56005 Jacksonville FL 32241-6005 Ph: () - | Advanced Maxillofacial Surgical Llc 1895 Kingsley Ave Suite 403 Orange Park FL 32073-4466 Ph: (904) 444-1578 |
NPI Number | 1821404914 |
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Provider Enumeration Date | 07/09/2014 |
Last Update Date | 07/09/2014 |
Identifier | Type | State | Issuer |
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1821404914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN18554 (Florida) | Primary |
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