| Albany Oral - Maxillofacial Surgery Group, Llp | |
|
2 Executive Park Dr Albany NY 12203-3700 | |
| (518) 446-1001 | |
| (518) 446-0802 |
| Full Name | Albany Oral - Maxillofacial Surgery Group, Llp |
|---|---|
| Speciality | Dentist |
| Location | 2 Executive Park Dr, Albany, New York |
| Authorized Official Name and Position | Lawrence James Busino (CO MEDICAL DIRECTOR) |
| Authorized Official Contact | 5184461001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Albany Oral - Maxillofacial Surgery Group, Llp 2 Executive Park Dr Albany NY 12203-3700 Ph: (518) 446-1001 | Albany Oral - Maxillofacial Surgery Group, Llp 2 Executive Park Dr Albany NY 12203-3700 Ph: (518) 446-1001 |
| NPI Number | 1679704431 |
|---|---|
| Provider Enumeration Date | 07/28/2009 |
| Last Update Date | 02/23/2015 |
| Medicare PECOS PAC ID | 2860533189 |
|---|---|
| Medicare Enrollment ID | O20100108000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679704431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Lawrence J Busino |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1487699211 PECOS PAC ID: 6204977390 Enrollment ID: I20100112000634 |
| Provider Name | Robert E Doriot |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1386937209 PECOS PAC ID: 8022082965 Enrollment ID: I20150624001640 |
| Provider Name | Mohamed Bayoumy |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1508229402 PECOS PAC ID: 6901193887 Enrollment ID: I20201019002644 |
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