# SAN DIEGO CENTER FOR ORAL AND MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1376803254
- **Authorized official:** MS. LYNN JANE O'KEEFE (ADMINISTRATOR)
- **Authorized official phone:** (858) 292-5175

## Contact information

- **Practice address:** 8008 FROST ST, SUITE 311, SAN DIEGO, CA 92123-4205
- **Practice address phone:** (858) 292-5175
- **Practice address fax:** (858) 292-9946
- **Mailing address:** 8008 FROST ST, SUITE 311, SAN DIEGO, CA 92123-4205
- **Mailing address phone:** (858) 292-5175
- **Mailing address fax:** (858) 292-9946

## 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:** 05/24/2012
- **Last updated:** 05/24/2012