Organization
OASIS ORAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYANT JONES (OWNER)
(215) 904-8951
Entity
Organization
Contact information
Practice address
9501 ROOSEVELT BLVD, SUITE 101, PHILADELPHIA, PA 19114-1025
(215) 904-8951
Mailing address
9501 ROOSEVELT BLVD, SUITE 101, PHILADELPHIA, PA 19114-1025
(215) 904-8951
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS038152
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102496758
—
PA
Enumeration date
01/06/2012
Last updated
01/19/2016
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