OrganizationActive
First Coast Oral & Facial Surgery, PA
NPI 1356601249 · Oral & Maxillofacial Surgery (D.M.D.) · St Augustine, FL
Provider details
- NPI number
- 1356601249
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Thomas Stakem, President(904) 529-8889
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
319 W Town Place
Suite 2
St Augustine, FL 32092
Phone: (904) 529-8889
Approximate (ZIP-level) locationGet directions
Mailing address
319 West Town Place #2
St. Augustine, FL 32092
Registry dates
- Enumerated
- 2012-05-24
- Last updated
- 2012-05-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.