# ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES

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

## Provider details

- **NPI number:** 1568655702
- **Authorized official:** DR. CHARLES WILLIAM ELWELL JR. D.M.D. (OWNER)
- **Authorized official phone:** (850) 651-6882

## Contact information

- **Practice address:** 7 CLIFFORD DR, SHALIMAR, FL 32579-1250
- **Practice address phone:** (850) 651-6882
- **Practice address fax:** (850) 651-6692
- **Mailing address:** 7 CLIFFORD DR, SHALIMAR, FL 32579-1250
- **Mailing address phone:** (850) 651-6882
- **Mailing address fax:** (850) 651-6692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN0012590 | FL | Yes |

## Other

- **Enumeration date:** 08/21/2007
- **Last updated:** 08/21/2007