Provider Demographics
NPI:1679800767
Name:FOREST HILLS ORAL SURGERY PLLC
Entity Type:Organization
Organization Name:FOREST HILLS ORAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-575-1010
Mailing Address - Street 1:6863 108TH ST
Mailing Address - Street 2:SITE 1D
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2975
Mailing Address - Country:US
Mailing Address - Phone:718-575-1010
Mailing Address - Fax:718-575-1015
Practice Address - Street 1:6863 108TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2975
Practice Address - Country:US
Practice Address - Phone:718-575-1010
Practice Address - Fax:718-575-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty