Organization
MADISON AVENUE ORAL SURGERY AND IMPLANT CENTER, PC
Active
Organization
MADISON AVENUE ORAL SURGERY AND IMPLANT CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOSES DATSON DDS (OWNER)
(212) 660-0305
Entity
Organization
Contact information
Practice address
295 MADISON AVE FL 28, NEW YORK, NY 10017-6351
(212) 660-0305
Mailing address
295 MADISON AVE FL 28, NEW YORK, NY 10017-6351
(212) 660-0305
(718) 284-5600
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
047288
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02282231
—
NY
Enumeration date
05/18/2011
Last updated
07/09/2024
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