# PATRIOT ORAL AND FACIAL SURGERY PLLC

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

## Provider details

- **NPI number:** 1174093835
- **Authorized official:** LORI A WASHNIGTON (CREDENTIALING)
- **Authorized official phone:** (757) 595-8964

## Contact information

- **Practice address:** 121 BULIFANTS BLVD STE B, WILLIAMSBURG, VA 23188-5736
- **Practice address phone:** (757) 297-6011
- **Mailing address:** 121 BULIFANTS BLVD STE B, WILLIAMSBURG, VA 23188-5736

## Taxonomy

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

## Other

- **Enumeration date:** 11/26/2018
- **Last updated:** 11/26/2018