Provider Demographics
NPI:1073779112
Name:QUALITY ORAL SURGERY CARE, P.C.
Entity Type:Organization
Organization Name:QUALITY ORAL SURGERY CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TABAROKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-848-6311
Mailing Address - Street 1:102 10 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4722
Mailing Address - Country:US
Mailing Address - Phone:718-544-4440
Mailing Address - Fax:718-233-2723
Practice Address - Street 1:102 10 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4722
Practice Address - Country:US
Practice Address - Phone:718-544-4440
Practice Address - Fax:718-233-2723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0476901223S0112X
NY0523301223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty