# MADISON AVENUE ORAL SURGERY AND IMPLANT CENTER, PC

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

## Provider details

- **NPI number:** 1700179124
- **Authorized official:** DR. MOSES DATSON DDS (OWNER)
- **Authorized official phone:** (212) 660-0305

## Contact information

- **Practice address:** 295 MADISON AVE FL 28, NEW YORK, NY 10017-6351
- **Practice address phone:** (212) 660-0305
- **Mailing address:** 295 MADISON AVE FL 28, NEW YORK, NY 10017-6351
- **Mailing address phone:** (212) 660-0305
- **Mailing address fax:** (718) 284-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 047288 | NY | Yes |

## Other

- **Enumeration date:** 05/18/2011
- **Last updated:** 07/09/2024