Organization
TOOTHFAIRY NYC ORAL & MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SASHA DAN (CO MANAGER)
(646) 331-9278
Entity
Organization
Contact information
Practice address
437 W 125TH ST, NEW YORK, NY 10027-4201
(212) 280-1635
(646) 837-0510
Mailing address
437 W 125TH ST, NEW YORK, NY 10027-4201
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NY
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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