Organization
LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC
Active
Organization
LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC
Active
Parent organization
LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LONG ISLAND ORAL & MAXILLOFACIAL SURGERY, PC
Authorized official
MRS. DEBRA MCQUILLAN (MANAGER)
(516) 294-9696
Entity
Organization
Contact information
Practice address
14 VANDERVENTER AVE, STE 260, PORT WASHINGTON, NY 11050-3737
(516) 944-8330
(516) 883-1598
Mailing address
14 VANDERVENTER AVE, STE 260, PORT WASHINGTON, NY 11050-3737
(516) 944-8330
(516) 883-1598
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NY
Other
Enumeration date
10/20/2006
Last updated
01/11/2008
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