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General NPI Number Information
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NPI Number | 1710098116
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Entity Type | Organization
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Legal Business Name | BRAVMAN LANGSTON AND ASSOCIATES ORAL & MAXILLOFACIAL SURGERY LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 03/10/2016
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Provider Practice Location Address
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Address Line | 236 MAIN ST
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City | FALMOUTH
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State | MA
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Zip | 02540
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Country | US
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Telephone | 508-495-3700
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Fax | 508-495-3702
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Provider Business Mailing Address
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Address Line | 114 WATERHOUSE RD
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City | BOURNE
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State | MA
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Zip | 02532-8340
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Country | US
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Telephone | 508-759-4495
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Fax | 508-759-0840
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN REYNOLDS LANGSTON
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Credential | D.D.S., M.S.
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Telephone | 508-759-4495
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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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