Organization
EAST 63RD STREET
Active
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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