Organization
BAY RAEA ORAL & FACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARY WAYNE STIMSON DMD (PRESIDENT)
(727) 738-1716
Entity
Organization
Contact information
Practice address
5636 GRAND BLVD, NEW PORT RICHEY, FL 34652-3875
(727) 845-3282
(727) 937-9213
Mailing address
5636 GRAND BLVD, NEW PORT RICHEY, FL 34652-3875
(727) 845-3282
(727) 937-9213
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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