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General NPI Number Information
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NPI Number | 1689850885
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Entity Type | Organization
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Legal Business Name | MAXILLOFACIAL SURGICAL ARTS OF MANHATTAN, PC
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 41 E 57TH ST SUITE 1204
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City | NEW YORK
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State | NY
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Zip | 10022-1983
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Country | US
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Telephone | 212-593-0303
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Fax | 212-688-3809
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Provider Business Mailing Address
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Address Line | 41 E 57TH ST SUITE 1204
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City | NEW YORK
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State | NY
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Zip | 10022-1983
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Country | US
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Telephone | 212-593-0303
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Fax | 212-688-3809
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM D WEBER
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Credential | D.M.D.
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Telephone | 212-593-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | NY
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