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General NPI Number Information
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NPI Number | 1851417406
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA ORAL & FACIAL SURGERY, P.A.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 11481 OLD SAINT AUGUSTINE RD STE 203
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1475
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Country | US
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Telephone | 904-309-5651
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Fax | 904-737-8326
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Provider Business Mailing Address
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Address Line | 11481 OLD ST. AUGUSTINE ROAD STE. 203
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1475
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Country | US
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Telephone | 904-309-5951
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Fax | 904-737-8326
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. RICK CRICI
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Credential |
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Telephone | 904-737-3617
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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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