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RED HILLS ORAL AND FACIAL SURGERY PA NPI 1427660703


NPI Information

NPI: 1427660703
Provider Name: RED HILLS ORAL AND FACIAL SURGERY, PA
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

CLIA Number: 10D2018906

Address:
2648 CENTENNIAL PL
TALLAHASSEE, FL
ZIP 32308
Phone: (850) 523-3000
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RED HILLS ORAL AND FACIAL SURGERY, PA is an oral and maxillofacial surgery dentist in Tallahassee, FL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. RED HILLS ORAL AND FACIAL SURGERY, PA NPI is 1427660703. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2648 CENTENNIAL PL
TALLAHASSEE, FL
ZIP 32308-572
Phone: (850) 523-3000
Fax: (850) 523-0831

The provider's authorized official is Russell Walther .
The authorized official title is Owner and has the following contact phone number (352) 284-0232.

The CLIA number assigned to this NPI record is 10D2018906 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/19/2020 and was last updated on 8/19/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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