Organization
NORTHWEST FLORIDA ORAL AND MAXILLOFACIAL SURGERY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT T. LAGGAN D.D.S (ORAL & MAXILLOFACIAL SURGEON)
(850) 478-7070
Entity
Organization
Contact information
Practice address
4850 N 9TH AVE STE 1, PENSACOLA, FL 32503-2407
(850) 478-7070
(850) 476-2513
Mailing address
4850 N 9TH AVE STE 1, PENSACOLA, FL 32503-2407
(850) 478-7070
(850) 476-2513
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN18924
FL
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DN18924
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073210900
—
FL
05
—
076708500
—
FL
Enumeration date
01/10/2011
Last updated
04/20/2011
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