Organization
BRONX ORAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERALD STEVEN FRIEDMAN DDS (OWNER)
(718) 292-7117
Entity
Organization
Contact information
Practice address
355 E 149TH ST RM 206, BRONX, NY 10455-3909
(718) 292-7117
(718) 292-5105
Mailing address
355 E 149TH ST RM 206, BRONX, NY 10455-3909
(718) 292-7117
(718) 292-5105
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659455194
—
NY
Enumeration date
03/04/2015
Last updated
03/04/2015
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