Individual provider · Type 1 NPI
Thomas E. Stakem, DDS, MD
Oral and Maxillofacial Surgery (Dentist) · Green Cove Springs, FL
Practice location
7175-01 U.s. Highway 17 South
Green Cove Springs, FL 32095
Fax (904) 529-8893
Mailing address
415 Sophia Ter
St. Augustine, FL 32095-6839
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | DN16222 (FL) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
About NPI 1932259405
Thomas E. Stakem, DDS, MD's National Provider Identifier is 1932259405, issued on Jan 10, 2007. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Green Cove Springs, FL. The record was last updated on Jul 8, 2007.