Organization
MARIO TUCHMAN ORAL & MAXILLOFACIAL SURGERY PPLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO TUCHMAN D.M.D., M.D. (PRESIDENT)
(646) 874-4004
Entity
Organization
Contact information
Practice address
353 LEXINGTON AVE, SUITE #700, NEW YORK, NY 10016-0941
(646) 874-4004
Mailing address
200 E 71ST ST, 11-J, NEW YORK, NY 10021-5137
(310) 749-8131
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
054229
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03144070
—
NY
Enumeration date
02/09/2012
Last updated
03/09/2017
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