Organization
CARDINAL ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Active
Organization
CARDINAL ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEER N. HATE DMD, MS (OWNER)
(386) 756-2580
Entity
Organization
Contact information
Practice address
870 DUNLAWTON AVE, SUITE 210, PORT ORANGE, FL 32127-9274
(386) 756-2580
(386) 756-2333
Mailing address
870 DUNLAWTON AVE, SUITE 210, PORT ORANGE, FL 32127-9274
(386) 756-2580
(386) 756-2333
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN15831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67275
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/22/2016
Last updated
12/22/2016
Update your record
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