# ADVANCED ORAL SURGERY

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

## Provider details

- **NPI number:** 1598181604
- **Authorized official:** MARA ROSENBERG (MANAGER)
- **Authorized official phone:** (646) 320-8247

## Contact information

- **Practice address:** 47 MAMARONECK AVE, WHITE PLAINS, NY 10601-4215
- **Practice address phone:** (914) 997-0566
- **Mailing address:** 47 MAMARONECK AVE, WHITE PLAINS, NY 10601-4215
- **Mailing address phone:** (914) 997-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 031496 | NY | Yes |

## Other

- **Enumeration date:** 03/13/2014
- **Last updated:** 03/13/2014