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St Augustine Oral & Facial Surgical Center Pa
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician in St Augustine, Florida
NPI 1629288824

St Augustine Oral & Facial Surgical Center Pa is a Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician based in Springdale, FL and is specialized in Plastic Surgery Within the Head and Neck. St Augustine Oral & Facial Surgical Center Pa practices in St Augustine, FL. The NPI Number for St Augustine Oral & Facial Surgical Center Pa is 1629288824 and holds a License No. DN15568 (Florida).

The current practice location address for St Augustine Oral & Facial Surgical Center Pa is 1301 Plantation Island Dr S, St Augustine, FL and can be reached out via phone at 904-460-0505 and via fax at 904-460-0506.

Location: 1301 Plantation Island Dr S, St Augustine, FL, 72766-7870
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629288824
Provider Name
St Augustine Oral & Facial Surgical Center Pa
Credential
Provider Entity Type
Organization
Address
1301 Plantation Island Dr S, St Augustine, FL, 72766-7870
Phone Number
904-460-0505
Fax Number
904-460-0506
Provider Enumeration Date
05/23/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
DD5857 01 FL RAILROAD MEDICARE GROUP
institution
Provider Business Practice Location Address Details
Address
1301 Plantation Island Dr S
City
St Augustine
State
Florida
Zip
32080-3108
Phone Number
904-460-0505
Fax Number
904-460-0506
person
Provider Business Mailing Address Details
Address
1301 Plantation Island Dr S
City
St Augustine
State
Florida
Zip
32080-3108
Phone Number
904-460-0505
Fax Number
904-460-0506
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
DN15568 (Florida)
Definition
The specialty of dentistry which includes 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.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Oral & Maxillofacial Surgery
Speciality
-
Taxonomy
204E00000X
License No.
DN15568 (Florida)
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Plastic Surgery
Speciality
Plastic Surgery Within the Head and Neck
Taxonomy
2082S0099X
License No.
DN15568 (Florida)
Definition
A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.
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