Healthcare Provider Details

I. General information

NPI: 1528388675
Provider Name (Legal Business Name): OROSURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 06/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

769 NORTHFIELD AVE SUITE 224
WEST ORANGE NJ
07052-1198
US

IV. Provider business mailing address

769 NORTHFIELD AVE SUITE 224
WEST ORANGE NJ
07052-1198
US

V. Phone/Fax

Practice location:
  • Phone: 973-731-8844
  • Fax: 973-731-9944
Mailing address:
  • Phone: 973-731-8844
  • Fax: 973-731-9944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. GERALD GELDZAHLER
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 973-731-8844