# ST. JOHNS ORAL SURGERY

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

## Provider details

- **NPI number:** 1710707328
- **Authorized official:** DR. ROGER MYERS DMD (OWNER)
- **Authorized official phone:** (904) 200-4375

## Contact information

- **Practice address:** 2050 SAINT JOHNS PKWY STE 101, ST JOHNS, FL 32259-4593
- **Practice address phone:** (904) 267-1295
- **Practice address fax:** (904) 299-2942
- **Mailing address:** 19 SAINT JOHNS MEDICAL PARK DR, ST AUGUSTINE, FL 32086-4342
- **Mailing address phone:** (904) 267-1295
- **Mailing address fax:** (904) 299-2942

## 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:** 10/16/2024
- **Last updated:** 10/16/2024