Organization
LONG ISLAND ORAL SURGERY ASSOCIATES, PC
Active
Parent organization
LONG ISLAND ORAL SURGERY ASSOCIATES, PC
Other names
Long Island Center for Oral and Maxillofacial Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONG ISLAND ORAL SURGERY ASSOCIATES, PC
Authorized official
MRS. KATHY LARSON (OFFICE MANAGER)
(516) 487-4100
Entity
Organization
Contact information
Practice address
1000 NORTHERN BLVD, SUITE 180, GREAT NECK, NY 11021-5338
(516) 487-4100
(516) 487-4041
Mailing address
959 BRUSH HOLLOW RD, SUITE 102, WESTBURY, NY 11590-1778
(516) 333-5900
(516) 333-5868
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
041527
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
044656
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
052978
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
057517-1
NY
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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