Organization
ORAL AND FACIAL SURGERY CENTER OF TALLAHASSEE
Active
Other names
Oral and Facial Surgery Center of
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRETT R TOLLEY D.D.S. (ORAL SURGEON / DENTIST)
(850) 386-4602
Entity
Organization
Contact information
Practice address
3375 CAPITAL CIR NE BLDG D, SUITE 2, TALLAHASSEE, FL 32308-3778
(850) 386-4602
(850) 386-4206
Mailing address
3330 CAPITAL OAKS DR STE 2, TALLAHASSEE, FL 32308-4513
(850) 386-4602
(850) 386-4206
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN17462
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
076811100
—
FL
01
—
87451
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/20/2007
Last updated
03/27/2019
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