Organization
FACIAL & ORAL SURGICAL SOLUTIONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STONE RANGARAJAN THAYER DMD, MD (PRESIDENT)
(386) 837-1236
Entity
Organization
Contact information
Practice address
400 TREEMONT DR, ORANGE CITY, FL 32763-7978
(386) 837-1236
(386) 960-7636
Mailing address
400 TREEMONT DR, ORANGE CITY, FL 32763-7978
(386) 837-1236
(386) 960-7636
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN 13469
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN 20469
FL
124Q00000X
Dental Hygienist
DH 17491
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
ME 114524
FL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
ME 114524
FL
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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