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Organization
ORAL SURGICAL INSTITUTE
Active
Organization
ORAL SURGICAL INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN HOWARD HARDEMAN DDS, MD (PRESIDENT)
(407) 625-3646
Entity
Organization
Contact information
Practice address
1291 WINTER GARDEN VINELAND RD, 150, WINTER GARDEN, FL 34787-6705
(407) 625-3646
Mailing address
PO BOX 691747, ORLANDO, FL 32869-1747
(407) 625-3646
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/05/2014
Last updated
07/23/2014
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