| Long Island Oral & Maxillofacial Surgery, Pc | |
|
14 Vanderventer Ave Ste 260 Port Washington NY 11050-3737 | |
| (516) 944-8330 | |
| (516) 883-1598 |
| Full Name | Long Island Oral & Maxillofacial Surgery, Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 14 Vanderventer Ave, Port Washington, New York |
| Authorized Official Name and Position | Debra Mcquillan (MANAGER) |
| Authorized Official Contact | 5162949696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Island Oral & Maxillofacial Surgery, Pc 14 Vanderventer Ave Ste 260 Port Washington NY 11050-3737 Ph: (516) 944-8330 | Long Island Oral & Maxillofacial Surgery, Pc 14 Vanderventer Ave Ste 260 Port Washington NY 11050-3737 Ph: (516) 944-8330 |
| NPI Number | 1710060223 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 01/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710060223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (New York) | Primary |
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