# RANDOLPH CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003860578
- **Authorized official:** DR. EDWARD A ROSENBAUM DMD (PARTNER)
- **Authorized official phone:** (973) 328-1555

## Contact information

- **Practice address:** 447 STATE ROUTE 10, SUITE 5, RANDOLPH, NJ 07869-2132
- **Practice address phone:** (973) 328-1555
- **Practice address fax:** (973) 328-3405
- **Mailing address:** 447 STATE ROUTE 10, SUITE 5, RANDOLPH, NJ 07869-2132
- **Mailing address phone:** (973) 328-1555
- **Mailing address fax:** (973) 328-3405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI02286202 | NJ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI13367 | NJ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI18357 | NJ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI21013 | NJ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI22430 | NJ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DI8562 | NJ | Yes |

## Other

- **Enumeration date:** 05/20/2006
- **Last updated:** 08/22/2020