Organization
EAST 63RD STREET
Active
Other names
Advanced Oral Surgery NYC
Organization subpart
No
Provider details
NPI number
Authorized official
BARUCH TETRI DDS (DDS)
(212) 759-5363
Entity
Organization
Contact information
Practice address
250 E 63RD ST, NEW YORK, NY 10065-7661
(212) 644-7009
Mailing address
250 E 63RD ST, NEW YORK, NY 10065-7661
(212) 644-7009
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
056681
NY
Other
Enumeration date
12/10/2013
Last updated
12/10/2013
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