Citrus Oral And Maxillofacial Surgery PA
Dentist, Oral and Maxillofacial Surgery in Crystal River, FL. Organization (NPI-2).
NPI number1447528906
StatusActive
Last updated in NPPESDec 12, 2011
Details
- NPI
- 1447528906
- Entity type
- Organization (NPI-2)
- Legal business name
- Citrus Oral And Maxillofacial Surgery PA
- Organization subpart
- No
- Enumeration date
- Dec 12, 2011
- Last updated
- Dec 12, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | 8810 | FL | Yes |
Practice location
6129 W Corporate Oaks DrCrystal River, FL 34429-8732
Phone 352-795-4994
Mailing address
6129 W Corporate Oaks DrCrystal River, FL 34429-8732
Phone 352-795-4994
Authorized official
Robert L Brockett
Owner/President
3527954994
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