# PARK SLOPE ORAL & MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1942687793
- **Authorized official:** MRS. ANIUSKA T GUTIERREZ (MANAGER)
- **Authorized official phone:** (718) 398-1969

## Contact information

- **Practice address:** 805 UNION STREET, BROOKLYN, NY 11215
- **Practice address phone:** (718) 398-1969
- **Practice address fax:** (718) 398-2792
- **Mailing address:** 805 UNION STREET, BROOKLYN, NY 11215
- **Mailing address phone:** (718) 398-1969
- **Mailing address fax:** (718) 398-2792

## Taxonomy

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

## Other

- **Enumeration date:** 04/30/2015
- **Last updated:** 04/30/2015