# TALLAHASSEE ORAL AND MAXILLOFACIAL SURGERY, PLLC

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

## Provider details

- **NPI number:** 1902398639
- **Authorized official:** RICARDO ORTIZ DMD, MD (ORAL AND MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (787) 556-6039

## Contact information

- **Practice address:** 3665 COOLIDGE CT STE 102, TALLAHASSEE, FL 32311-7894
- **Practice address phone:** (850) 431-6725
- **Practice address fax:** (850) 431-6859
- **Mailing address:** 3665 COOLIDGE CT STE 102, TALLAHASSEE, FL 32311-7894
- **Mailing address phone:** (850) 431-6725
- **Mailing address fax:** (850) 431-6859

## 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:** 05/30/2018
- **Last updated:** 06/04/2021