# IMPLANTIS ORAL & FACIAL SURGERY, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114291002
- **Authorized official:** GARY RASKA DMD (PRESIDENT)
- **Authorized official phone:** (941) 923-0033

## Contact information

- **Practice address:** 3940 SWIFT RD, SARASOTA, FL 34231-6541
- **Practice address phone:** (941) 923-0033
- **Practice address fax:** (941) 922-4621
- **Mailing address:** 3940 SWIFT RD, SARASOTA, FL 34231-6541
- **Mailing address phone:** (941) 923-0033
- **Mailing address fax:** (941) 922-4621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN18583 | FL | Yes |

## Other

- **Enumeration date:** 02/24/2012
- **Last updated:** 02/24/2012