# HUNTSVILLE ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES, PC

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

## Provider details

- **NPI number:** 1386740140
- **Authorized official:** DR. PHILIP BRENT ELLEDGE DMD (OWNER)
- **Authorized official phone:** (256) 534-5028

## Contact information

- **Practice address:** 2314 PANSY ST SW, HUNTSVILLE, AL 35801-3803
- **Practice address phone:** (256) 534-5028
- **Practice address fax:** (256) 534-5073
- **Mailing address:** 2314 PANSY ST SW, HUNTSVILLE, AL 35801-3803
- **Mailing address phone:** (256) 534-5028
- **Mailing address fax:** (256) 534-5073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5313 | AL | Yes |

## Other

- **Enumeration date:** 09/16/2006
- **Last updated:** 08/15/2007