Organization
FL ORAL AND FACIAL SURGERY LLC
Active
Other names
Allez Dental Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE HOLLOWAY (DIRECTOR OF RCM)
(854) 200-7970
Entity
Organization
Contact information
Practice address
11424 N 56TH ST, TEMPLE TERRACE, FL 33617-2237
(813) 373-4573
Mailing address
3700 INGLESIDE BLVD, LADSON, SC 29456-4141
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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