Provider Demographics
NPI:1508011305
Name:ALL COUNTY ORAL & MAXILLOFACIAL SURGERY LLP
Entity Type:Organization
Organization Name:ALL COUNTY ORAL & MAXILLOFACIAL SURGERY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:O
Authorized Official - Last Name:CHAVKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-752-1033
Mailing Address - Street 1:115 BROADHOLLOW RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4915
Mailing Address - Country:US
Mailing Address - Phone:631-752-1033
Mailing Address - Fax:631-752-1034
Practice Address - Street 1:115 BROADHOLLOW RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4701
Practice Address - Country:US
Practice Address - Phone:631-752-1033
Practice Address - Fax:631-752-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty