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Organization
KEYSTONE ORAL SURGERY ASSOCIATES PC
Active
Organization
KEYSTONE ORAL SURGERY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRANATHI REDDY DDS (PRESIDENT)
(570) 884-8321
Entity
Organization
Contact information
Practice address
30 BALDWIN BLVD STE 95, SHAMOKIN DAM, PA 17876-9520
(570) 884-8321
(570) 256-1772
Mailing address
78 WINDSOR RD, BELLE MEAD, NJ 08502-5851
(267) 809-2364
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
02/05/2023
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