# PROFESSIONAL ORAL SURGERY ALLIANCE OF DOWNSTATE NEW YORK PLLC

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

## Provider details

- **NPI number:** 1700032562
- **Authorized official:** KAYLA GRAHAM (CREDENTIALING)
- **Authorized official phone:** (724) 698-2474

## Contact information

- **Practice address:** 1075 CENTRAL PARK AVE, SUITE 207, SCARSDALE, NY 10583-3242
- **Practice address phone:** (914) 472-5252
- **Practice address fax:** (914) 722-5987
- **Mailing address:** 125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
- **Mailing address phone:** (724) 698-2500

## Taxonomy

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

## Other

- **Enumeration date:** 08/13/2008
- **Last updated:** 12/10/2024