# WARREN ORAL & MAXILLOFACIAL SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1770749426
- **Authorized official:** DR. DANIEL PETER SULLIVAN DDS (ORAL SURGEON/ PARTNER)
- **Authorized official phone:** (908) 222-7922

## Contact information

- **Practice address:** 31 MOUNTAIN BLVD BLDG T, WARREN, NJ 07059-5648
- **Practice address phone:** (908) 222-7922
- **Practice address fax:** (908) 222-7923
- **Mailing address:** 31 MOUNTAIN BLVD BLDG T, WARREN, NJ 07059-5648
- **Mailing address phone:** (908) 222-7922
- **Mailing address fax:** (908) 222-7923

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 02036700 | NJ | Yes |

## Other

- **Enumeration date:** 08/01/2008
- **Last updated:** 08/01/2008