ADVANCED MAXILLOFACIAL SURGICAL LLC NPI 1821404914

NPI Information

ADVANCED MAXILLOFACIAL SURGICAL LLC is an oral and maxillofacial surgery dentist in Orange Park, FL. The provider is an oral and maxillofacial surgery dentist specialized in 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. ADVANCED MAXILLOFACIAL SURGICAL LLC NPI is 1821404914. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1895 KINGSLEY AVE
SUITE 403
ORANGE PARK, FL
ZIP 32073-466
Phone: (904) 444-1578

The provider's authorized official is Jason Lee .
The authorized official title is Owner and has the following contact phone number (904) 444-1578.

The enumeration date for this NPI number is 7/9/2014 and was last updated on 7/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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