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Organization
SOUTH SHORE ORAL SURGERY ASSOC PC
Active
Organization
SOUTH SHORE ORAL SURGERY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA A VANNESS (OFFICE MANAGER)
(516) 766-0580
Entity
Organization
Contact information
Practice address
24 MAPLE AVE, SOUTH SHORE ORAL SURGERY ASSOC PC SUITE 6, ROCKVILLE CENTRE, NY 11570
(516) 766-0580
(516) 766-6755
Mailing address
24 MAPLE AVE, SOUTH SHORE ORAL SURGERY ASSOC PC SUITE 6, ROCKVILLE CENTRE, NY 11570
(516) 766-0580
(516) 766-6755
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
NULL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
06/20/2008
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