# BOCA RATON CENTER FOR ORAL FACIAL & IMPLANT SURGERY, LLC

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

## Provider details

- **NPI number:** 1285869933
- **Authorized official:** MS. CARLA PICCONE (INSURANCE COORDINATOR)
- **Authorized official phone:** (561) 826-2002

## Contact information

- **Practice address:** 2499 GLADES RD, SUITE 309, BOCA RATON, FL 33431-7202
- **Practice address phone:** (561) 826-2002
- **Practice address fax:** (561) 826-2003
- **Mailing address:** 2499 GLADES RD, SUITE 309, BOCA RATON, FL 33431-7202
- **Mailing address phone:** (561) 826-2002
- **Mailing address fax:** (561) 826-2003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN16134 | FL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN17306 | FL | — |

## Other

- **Enumeration date:** 05/26/2009
- **Last updated:** 07/15/2010