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Organization
ORAL AND MAXILLOFACIAL SURGERY OF QUEENS
Active
Organization
ORAL AND MAXILLOFACIAL SURGERY OF QUEENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARIAN SADEGHI (MANAGER)
(718) 565-5005
Entity
Organization
Contact information
Practice address
3775 103RD ST, CORONA, NY 11368-1979
(718) 565-5005
Mailing address
3775 103RD ST, CORONA, NY 11368-1979
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
051861
NY
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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