FIRST COAST ORAL & FACIAL SURGERY, PA

ST AUGUSTINE, FL
NPI1356601249
Entity TypeOrganization
Authorized ContactTHOMAS E STAKEM
President
904-529-8889
Organization Subpart ?No
Primary Taxonomy204E00000X Oral & Maxillofacial Surgery
Enumeration Date2012-05-24
Last Update Date2012-05-24
Business Address
FIRST COAST ORAL & FACIAL SURGERY, PA
319 W TOWN PLACE SUITE 2
ST AUGUSTINE, FL 32092
Phone number: 904-529-8889
Mailing Address
FIRST COAST ORAL & FACIAL SURGERY, PA
319 WEST TOWN PLACE #2
ST. AUGUSTINE, FL 32092
Phone number: 904-529-8889
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