Provider Demographics
NPI:1790149235
Name:NEW ROCHELLE ORAL SURGERY
Entity Type:Organization
Organization Name:NEW ROCHELLE ORAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-472-5252
Mailing Address - Street 1:77 QUAKER RIDGE RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-2808
Mailing Address - Country:US
Mailing Address - Phone:914-235-1235
Mailing Address - Fax:914-235-0794
Practice Address - Street 1:77 QUAKER RIDGE RD
Practice Address - Street 2:SUITE 212
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-2808
Practice Address - Country:US
Practice Address - Phone:914-235-1235
Practice Address - Fax:914-235-0794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty