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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
134 MINEOLA BLVD., 3 FLOOR, MINEOLA, NY 11501
(516) 294-9696
(516) 294-3531
Mailing address
134 MINEOLA BLVD., 3 FLOOR, MINEOLA, NY 11501
(516) 294-9696
(516) 294-3531

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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