Organization
EAST END ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK ANDREW NELSON DDS (PRESIDENT)
(631) 728-1300
Entity
Organization
Contact information
Practice address
240 W MONTAUK HWY, HAMPTON BAYS, NY 11946-3510
(631) 728-1300
(631) 728-5165
Mailing address
240 W MONTAUK HWY, HAMPTON BAYS, NY 11946-3510
(631) 728-1300
(631) 728-5165
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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