# RODNEY RASTEGAR DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Progressive Oral Surgery of Long Island
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508195975
- **Authorized official:** MRS. JENNIFER L DAVILA (OFFICE MANAGER)
- **Authorized official phone:** (516) 741-4415

## Contact information

- **Practice address:** 601 FRANKLIN AVE, SUITE 110, GARDEN CITY, NY 11530
- **Practice address phone:** (516) 741-4415
- **Practice address fax:** (516) 741-4417
- **Mailing address:** 23 BOND STREET, GREAT NECK, NY 11021
- **Mailing address phone:** (516) 482-0329
- **Mailing address fax:** (516) 482-0401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 048692 | NY | Yes |

## Other

- **Enumeration date:** 12/15/2009
- **Last updated:** 01/13/2016