# RIVERSIDE ORAL SURGERY - LIVINGSTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverside Oral Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255826939
- **Authorized official:** MISS LISA D BROWN (OFFICE MANAGER)
- **Authorized official phone:** (201) 487-6565

## Contact information

- **Practice address:** 340 E NORTHFIELD RD STE 1C, LIVINGSTON, NJ 07039-4892
- **Practice address phone:** (973) 992-4750
- **Mailing address:** 130 KINDERKAMACK RD STE 204, RIVER EDGE, NJ 07661-1931
- **Mailing address phone:** (201) 487-6565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22DI02584805 | NJ | Yes |

## Other

- **Enumeration date:** 06/26/2018
- **Last updated:** 09/26/2022