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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