# MANHATTAN MAXILLOFACIAL SURGERY GROUP

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

## Provider details

- **NPI number:** 1629233358
- **Authorized official:** ANTONIO L DEL VALLE DMD, MD (ORAL AND MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (212) 245-5801

## Contact information

- **Practice address:** 45 W 54TH ST, SUITE 1E, NEW YORK, NY 10019-5404
- **Practice address phone:** (212) 245-5801
- **Practice address fax:** (212) 977-9486
- **Mailing address:** 45 W 54TH ST, SUITE 1E, NEW YORK, NY 10019-5404
- **Mailing address phone:** (212) 245-5801
- **Mailing address fax:** (212) 977-9486

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 048825-1 | NY | Yes |

## Other

- **Enumeration date:** 07/22/2008
- **Last updated:** 07/22/2008