Provider Demographics
NPI:1003145830
Name:DR. HOWARD A. ISRAEL ORAL & MAXILLOFACIAL SURGERY, PLLC
Entity Type:Organization
Organization Name:DR. HOWARD A. ISRAEL ORAL & MAXILLOFACIAL SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISRAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-466-6991
Mailing Address - Street 1:12 BOND ST
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2005
Mailing Address - Country:US
Mailing Address - Phone:516-466-6991
Mailing Address - Fax:516-466-4296
Practice Address - Street 1:12 BOND ST
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2005
Practice Address - Country:US
Practice Address - Phone:516-466-6991
Practice Address - Fax:516-466-4296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0329341223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty