| Cardinal Oral & Maxillofacial Surgery Associates | |
|
870 Dunlawton Ave Suite 210 Port Orange FL 32127-9274 | |
| (386) 756-2580 | |
| (386) 756-2333 |
| Full Name | Cardinal Oral & Maxillofacial Surgery Associates |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 870 Dunlawton Ave, Port Orange, Florida |
| Authorized Official Name and Position | Sameer N. Hate (OWNER) |
| Authorized Official Contact | 3867562580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cardinal Oral & Maxillofacial Surgery Associates 870 Dunlawton Ave Suite 210 Port Orange FL 32127-9274 Ph: (386) 756-2580 | Cardinal Oral & Maxillofacial Surgery Associates 870 Dunlawton Ave Suite 210 Port Orange FL 32127-9274 Ph: (386) 756-2580 |
| NPI Number | 1114462496 |
|---|---|
| Provider Enumeration Date | 12/22/2016 |
| Last Update Date | 12/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114462496 | NPI | - | NPPES |
| 67275 | Other | FL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN15831 (Florida) | Primary |
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