Organization
SOUTH BEDFORD ORAL & MAXILLOFACIAL SURGERY PLLC
Active
Organization
SOUTH BEDFORD ORAL & MAXILLOFACIAL SURGERY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON BAKER DMD (OWNER)
(914) 242-1142
Entity
Organization
Contact information
Practice address
105 SOUTH BEDFORD ROAD, SUITE 330, MT. KISCO, NY 10549-3466
(914) 242-1142
(914) 242-1147
Mailing address
105 SOUTH BEDFORD ROAD, SUITE 330, MT. KISCO, NY 10549-3466
(914) 242-1142
(914) 242-1147
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
049711
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
051590
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
052234
NY
Other
Enumeration date
06/09/2009
Last updated
02/08/2017
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