# LONG ISLAND ORAL SURGERY ASSOCIATES PC

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

## Provider details

- **NPI number:** 1760780621
- **Authorized official:** MRS. MARY KEARNS (PRACTICE COORDINATOR)
- **Authorized official phone:** (631) 421-2544

## Contact information

- **Practice address:** 61 E MAIN ST, HUNTINGTON, NY 11743-2812
- **Practice address phone:** (631) 421-2544
- **Practice address fax:** (631) 421-0948
- **Mailing address:** 61 E MAIN ST, HUNTINGTON, NY 11743-2812
- **Mailing address phone:** (631) 421-2544
- **Mailing address fax:** (631) 421-0948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 041527 | NY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 044656 | NY | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 052978 | NY | — |

## Other

- **Enumeration date:** 03/02/2011
- **Last updated:** 03/02/2011