| Commack Oral And Maxillofacial Surgeons Pc | |
|
160 Commack Rd Suite M1 Commack NY 11725-3412 | |
| (631) 499-7266 | |
| (631) 499-7525 |
| Full Name | Commack Oral And Maxillofacial Surgeons Pc |
|---|---|
| Speciality | Dentist |
| Location | 160 Commack Rd, Commack, New York |
| Authorized Official Name and Position | David Miller (PRESIDENT) |
| Authorized Official Contact | 6314997266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Commack Oral And Maxillofacial Surgeons Pc 160 Commack Rd Suite M1 Commack NY 11725-3412 Ph: (631) 499-7266 | Commack Oral And Maxillofacial Surgeons Pc 160 Commack Rd Suite M1 Commack NY 11725-3412 Ph: (631) 499-7266 |
| NPI Number | 1518234392 |
|---|---|
| Provider Enumeration Date | 11/22/2011 |
| Last Update Date | 11/22/2011 |
| Medicare PECOS PAC ID | 2567639479 |
|---|---|
| Medicare Enrollment ID | O20120118000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518234392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 041250 (New York) | Primary |
| Provider Name | David Mark Miller |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1285658120 PECOS PAC ID: 3476720384 Enrollment ID: I20120118000061 |
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