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Organization
PROFESSIONAL ORAL SURGERY ALLIANCE OF UPSTATE NEW YORK, PLLC
Active
Organization
PROFESSIONAL ORAL SURGERY ALLIANCE OF UPSTATE NEW YORK, PLLC
Active
Other names
Oral & Maxillofacial Surgery Associates of WNY Olean, Oral & Maxillofacial Surgery Associates of WNY West Seneca, Oral & Maxillofacial Surgery Associates of WNY Depew
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA GRAHAM (CREDENTIALING SPECIALIST)
(724) 698-2474
Entity
Organization
Contact information
Practice address
4708 TRANSIT RD, DEPEW, NY 14043-4862
(716) 668-3315
Mailing address
125 ENTERPRISE DR STE 100, 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
03/06/2025
Last updated
03/06/2025
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