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Organization
STONY BROOK ORAL AND FACIAL SURGERY PC
Active
Organization
STONY BROOK ORAL AND FACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PROOTHI DMD, MD (OWNER)
(631) 675-9601
Entity
Organization
Contact information
Practice address
207 HALLOCK RD, SUITE 2, STONY BROOK, NY 11790-3033
(631) 675-9601
(631) 675-9602
Mailing address
207 HALLOCK RD, SUITE 2, STONY BROOK, NY 11790-3033
(631) 675-9601
(631) 675-9602
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
051735-1
NY
Other
Enumeration date
04/19/2017
Last updated
02/29/2024
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