Healthcare Provider Details

I. General information

NPI: 1982989273
Provider Name (Legal Business Name): AURORA ORAL SURGERY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2011
Last Update Date: 10/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15-01 BROADWAY SUITE 18
FAIRLAWN NJ
07410
US

IV. Provider business mailing address

15-01 BROADWAY SUITE 18
FAIRLAWN NJ
07410
US

V. Phone/Fax

Practice location:
  • Phone: 201-475-1600
  • Fax: 201-796-6444
Mailing address:
  • Phone: 201-967-8425
  • Fax: 201-263-4665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22DI02285400
License Number StateNJ

VIII. Authorized Official

Name: ESHANSH ARORA
Title or Position: DDS
Credential: DDS
Phone: 201-475-1600