# RANDOLPH CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RANDOLPH CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1659281061
- **Legal business name:** RANDOLPH CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, LLC
- **Authorized official:** MICHAELA MUNIZ (VP, PAYOR RELATIONS)
- **Authorized official phone:** (469) 324-3242

## Contact information

- **Practice address:** 9 FISHERS LN STE C, SPARTA, NJ 07871-2441
- **Practice address phone:** (973) 512-2266
- **Mailing address:** 9 FISHERS LN STE C, SPARTA, NJ 07871-2441
- **Mailing address phone:** (973) 512-2266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |

## Other

- **Enumeration date:** 09/09/2026
- **Last updated:** 09/09/2026