Organization
ORAL AND MAXILLOFACIAL SURGERY OF QUEENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARIAN SADEGHI (MANAGER)
(718) 565-5005
Entity
Organization
Contact information
Practice address
3775 103RD ST, CORONA, NY 11368-1979
(718) 565-5005
Mailing address
3775 103RD ST, CORONA, NY 11368-1979
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
051861
NY
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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