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General NPI Number Information
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NPI Number | 1679800767
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Entity Type | Organization
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Legal Business Name | FOREST HILLS ORAL SURGERY PLLC
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Dates
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Enumeration Date | 11/10/2009
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 6863 108TH ST SUITE 1D
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City | FOREST HILLS
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State | NY
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Zip | 11375-2975
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Country | US
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Telephone | 718-575-1010
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Fax | 718-575-1015
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Provider Business Mailing Address
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Address Line | 6863 108TH ST SITE 1D
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City | FOREST HILLS
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State | NY
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Zip | 11375-2975
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Country | US
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Telephone | 718-575-1010
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Fax | 718-575-1015
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. FLORA BABECK
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Credential |
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Telephone | 718-575-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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