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General NPI Number Information
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NPI Number | 1285237347
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Entity Type | Organization
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Legal Business Name | CITY BEAUTIFUL ORAL & FACIAL SURGERY LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 1640 N MAITLAND AVE # 1000
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City | MAITLAND
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State | FL
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Zip | 32751-3320
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Country | US
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Telephone | 407-900-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 1640 N MAITLAND AVE # 1000
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City | MAITLAND
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State | FL
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Zip | 32751-3320
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Country | US
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Telephone | 407-900-3366
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Fax | 321-800-9394
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Authorized Official
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Title or Position | DOCTOR, MANAGER
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Name | JORGE J VALLE
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Credential | DMD, MD
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Telephone | 407-617-3726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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