# EAST BAY ORAL SURGERY

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

## Provider details

- **NPI number:** 1285692731
- **Authorized official:** DR. STEPHEN NICHOLAS BAKIAS DDS (OWNER)
- **Authorized official phone:** (401) 435-4240

## Contact information

- **Practice address:** 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI 02914
- **Practice address phone:** (401) 435-4240
- **Practice address fax:** (401) 435-4245
- **Mailing address:** 2224 PAWTUCKET AVENUE, EAST PROVIDENCE, RI 02914
- **Mailing address phone:** (401) 435-4240
- **Mailing address fax:** (401) 435-4245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 1686 | RI | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 16987 | MA | — |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 04/20/2008