# CHAVKIN ORAL AND MAXILLOFACIAL SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** All County Oral & Maxillofacial Surgery - New Hyde Park
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700420429
- **Authorized official:** YANELIN GONZALEZ (MANAGER)
- **Authorized official phone:** (516) 755-7960

## Contact information

- **Practice address:** 414 JERICHO TPKE STE 2, NEW HYDE PARK, NY 11040-4510
- **Practice address phone:** (516) 755-7960
- **Practice address fax:** (516) 231-2136
- **Mailing address:** 414 JERICHO TPKE STE 2, NEW HYDE PARK, NY 11040-4510
- **Mailing address phone:** (516) 755-7960
- **Mailing address fax:** (516) 231-2136

## 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:** 11/06/2019
- **Last updated:** 11/06/2019