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General NPI Number Information
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NPI Number | 1316976848
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Entity Type | Organization
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Legal Business Name | BAY AREA ORAL & FACIAL SURGERY
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 1993 COUNTRY ROAD 1
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City | DUNEDIN
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State | FL
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Zip | 34698-2833
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Country | US
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Telephone | 727-738-1716
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Fax | 727-738-0472
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Provider Business Mailing Address
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Address Line | 1993 COUNTRY ROAD 1
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City | DUNEDIN
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State | FL
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Zip | 34698-2833
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Country | US
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Telephone | 727-738-1716
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Fax | 727-738-0472
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Authorized Official
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Title or Position | SENIOR PARTNER
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Name | DR. CARY WAYNE STIMSON
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Credential | DMD
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Telephone | 727-738-1716
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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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