Organization
ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES WILLIAM ELWELL JR. D.M.D. (OWNER)
(850) 651-6882
Entity
Organization
Contact information
Practice address
7 CLIFFORD DR, SHALIMAR, FL 32579-1250
(850) 651-6882
(850) 651-6692
Mailing address
7 CLIFFORD DR, SHALIMAR, FL 32579-1250
(850) 651-6882
(850) 651-6692
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN0012590
FL
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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