# STONY BROOK ORAL AND FACIAL SURGERY PC

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

## Provider details

- **NPI number:** 1497289037
- **Authorized official:** DR. MICHAEL PROOTHI DMD, MD (OWNER)
- **Authorized official phone:** (631) 675-9601

## Contact information

- **Practice address:** 207 HALLOCK RD, SUITE 2, STONY BROOK, NY 11790-3033
- **Practice address phone:** (631) 675-9601
- **Practice address fax:** (631) 675-9602
- **Mailing address:** 207 HALLOCK RD, SUITE 2, STONY BROOK, NY 11790-3033
- **Mailing address phone:** (631) 675-9601
- **Mailing address fax:** (631) 675-9602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 051735-1 | NY | Yes |

## Other

- **Enumeration date:** 04/19/2017
- **Last updated:** 02/29/2024