Organization
POCONO ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN POLITO (OFFICE MANAGER)
(845) 343-7529
Entity
Organization
Contact information
Practice address
451 EAST MAIN STREET, MIDDLETOWN, NY 10940
(845) 343-7529
(845) 343-7532
Mailing address
451 EAST MAIN STREET, MIDDLETOWN, NY 10940
(845) 343-7529
(845) 343-7532
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
044627-1
NY
1223P0106X
Oral and Maxillofacial Pathology Dentistry
045048-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
051165
NY
Other
Enumeration date
06/15/2007
Last updated
04/24/2008
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