Provider Demographics
NPI:1396980512
Name:HUNTINGTON ORAL & MAXILLOFACIAL SURGERY
Entity type:Organization
Organization Name:HUNTINGTON ORAL & MAXILLOFACIAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MAIORINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-421-0100
Mailing Address - Street 1:215 E MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7904
Mailing Address - Country:US
Mailing Address - Phone:631-421-0100
Mailing Address - Fax:631-421-7101
Practice Address - Street 1:215 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7904
Practice Address - Country:US
Practice Address - Phone:631-421-0100
Practice Address - Fax:631-421-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty