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Organization
ADVANCED ORAL SURGERY
Active
Organization
ADVANCED ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARA ROSENBERG (MANAGER)
(646) 320-8247
Entity
Organization
Contact information
Practice address
47 MAMARONECK AVE, WHITE PLAINS, NY 10601-4215
(914) 997-0566
Mailing address
47 MAMARONECK AVE, WHITE PLAINS, NY 10601-4215
(914) 997-0566
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
031496
NY
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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