Organization
STONY BROOK ORAL AND FACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PROOTHI DMD, MD (OWNER)
(631) 675-9601
Entity
Organization
Contact information
Practice address
207 HALLOCK RD, SUITE 2, STONY BROOK, NY 11790-3033
(631) 675-9601
(631) 675-9602
Mailing address
207 HALLOCK RD, SUITE 2, STONY BROOK, NY 11790-3033
(631) 675-9601
(631) 675-9602
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
051735-1
NY
Other
Enumeration date
04/19/2017
Last updated
02/29/2024
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