Organization
LONG ISLAND ORAL SURGERY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY KEARNS (PRACTICE COORDINATOR)
(631) 421-2544
Entity
Organization
Contact information
Practice address
61 E MAIN ST, HUNTINGTON, NY 11743-2812
(631) 421-2544
(631) 421-0948
Mailing address
61 E MAIN ST, HUNTINGTON, NY 11743-2812
(631) 421-2544
(631) 421-0948
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
041527
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
044656
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
052978
NY
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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