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Organization
PROFESSIONAL ORAL SURGERY ALLIANCE OF DOWNSTATE NEW YORK PLLC
Active
Organization
PROFESSIONAL ORAL SURGERY ALLIANCE OF DOWNSTATE NEW YORK PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA GRAHAM (CREDENTIALING)
(724) 698-2474
Entity
Organization
Contact information
Practice address
1075 CENTRAL PARK AVE, SUITE 207, SCARSDALE, NY 10583-3242
(914) 472-5252
(914) 722-5987
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/13/2008
Last updated
12/10/2024
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