Organization
EASTSIDE ORAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM S BRISMAN D.M.D (OWNER)
(212) 348-0020
Entity
Organization
Contact information
Practice address
231 E 106TH ST, NEW YORK, NY 10029-4005
(212) 348-0020
(646) 219-2039
Mailing address
231 E 106TH ST, NEW YORK, NY 10029-4005
(212) 348-0020
(646) 219-2039
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
047259
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02249521
—
NY
Enumeration date
09/22/2009
Last updated
09/22/2009
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