Organization
ASSOCIATES IN ORAL AND MAXILLOFACIAL , SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDOLPH A HOLLY DDS (OWNER)
(607) 757-0455
Entity
Organization
Contact information
Practice address
1003 MONROE ST, ENDICOTT, NY 13760-5221
(607) 757-0455
(607) 757-9375
Mailing address
1003 MONROE ST, ENDICOTT, NY 13760-5221
(607) 757-0455
(607) 757-9375
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0369901
NY
Other
Enumeration date
03/01/2007
Last updated
02/11/2008
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