Healthcare Provider Details

I. General information

NPI: 1285842831
Provider Name (Legal Business Name): ISABELL G OXFORD DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HEALTH PARK BLVD SUITE 216
ST AUGUSTINE FL
32086-5797
US

IV. Provider business mailing address

201 HEALTH PARK BLVD SUITE 216
ST AUGUSTINE FL
32086-5797
US

V. Phone/Fax

Practice location:
  • Phone: 904-810-2345
  • Fax: 904-810-5334
Mailing address:
  • Phone: 904-810-2345
  • Fax: 904-810-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN14302
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: