# EASTSIDE ORAL SURGERY

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

## Provider details

- **NPI number:** 1427382563
- **Authorized official:** ADAM S BRISMAN D.M.D (OWNER)
- **Authorized official phone:** (212) 348-0020

## Contact information

- **Practice address:** 231 E 106TH ST, NEW YORK, NY 10029-4005
- **Practice address phone:** (212) 348-0020
- **Practice address fax:** (646) 219-2039
- **Mailing address:** 231 E 106TH ST, NEW YORK, NY 10029-4005
- **Mailing address phone:** (212) 348-0020
- **Mailing address fax:** (646) 219-2039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 047259 | NY | Yes |

## Other

- **Enumeration date:** 09/22/2009
- **Last updated:** 09/22/2009