# PROFESSIONAL ORAL SURGERY ALLIANCE OF NEW JERSEY, LLC

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

## Provider details

- **NPI number:** 1366051195
- **Authorized official:** LAUREN HOWARD MA (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (757) 576-5479

## Contact information

- **Practice address:** 1530 PALISADE AVE, FORT LEE, NJ 07024-5471
- **Practice address phone:** (201) 585-8282
- **Mailing address:** 11 S MILL ST, NEW CASTLE, PA 16101-3680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2020
- **Last updated:** 07/28/2020