# KEYSTONE ORAL SURGERY ASSOCIATES PC

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

## Provider details

- **NPI number:** 1518670165
- **Authorized official:** DR. PRANATHI REDDY DDS (PRESIDENT)
- **Authorized official phone:** (570) 884-8321

## Contact information

- **Practice address:** 30 BALDWIN BLVD STE 95, SHAMOKIN DAM, PA 17876-9520
- **Practice address phone:** (570) 884-8321
- **Practice address fax:** (570) 256-1772
- **Mailing address:** 78 WINDSOR RD, BELLE MEAD, NJ 08502-5851
- **Mailing address phone:** (267) 809-2364

## Taxonomy

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

## Other

- **Enumeration date:** 12/28/2022
- **Last updated:** 02/05/2023