Associates in Oral and Maxillofacial , Surgery

Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Endicott, NY

NPI 1316075583 · NPPES record last updated Feb 11, 2008

Key facts

NPI
1316075583
Entity type
Organization (NPI type 2)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
0369901 (NY)
Legal business name
ASSOCIATES IN ORAL AND MAXILLOFACIAL , SURGERY
Practice address
1003 Monroe St
Endicott, NY 13760-5221
Phone
(607) 757-0455
Fax
(607) 757-9375
NPI assigned
Mar 1, 2007
Organization subpart
No

Authorized official

Name
Randolph A Holly, DDS
Title
Owner
Phone
(607) 757-0455

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X SINGLE SPECIALTY GROUP
1223S0112X 0369901 NY Yes

Addresses

Primary practice location

1003 Monroe St
Endicott, NY 13760-5221

Mailing address

1003 Monroe St
Endicott, NY 13760-5221
Phone (607) 757-0455

Other providers in Endicott, NY

All providers in Endicott, NY · Oral and Maxillofacial Surgery (Dentist) in New York

Sources for this page

Verify at the official NPI Registry.