# RAWSON & BRAXTON ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES OF WEST FL

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

## Provider details

- **NPI number:** 1265754824
- **Authorized official:** MRS. ELLA MANZIEK (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (850) 477-8482

## Contact information

- **Practice address:** 1100 AIRPORT BLVD STE B, PENSACOLA, FL 32504-8622
- **Practice address phone:** (850) 477-8482
- **Practice address fax:** (850) 477-7604
- **Mailing address:** 1100 AIRPORT BLVD STE B, PENSACOLA, FL 32504-8622
- **Mailing address phone:** (850) 477-8482
- **Mailing address fax:** (850) 477-7604

## 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:** 02/24/2010
- **Last updated:** 02/24/2010