Fayetteville-Manlius Oral Surgery, P.C

LBN: Fayetteville-Manlius Oral Surgery, P.C
Fayetteville-Manlius Oral Surgery, P.C is an health care organization with primary practice located at 8240 Cazenovia Rd Ste 60 , Manlius NY 13104-8814. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty. Fayetteville-Manlius Oral Surgery, P.C can be contacted via phone (315) 692-0449, or through Elliot, Edious Kwaipa via phone (315) 692-0449.

Contact Information

Primary practice address
8240 Cazenovia Rd Ste 60 Manlius NY 13104-8814
Phone: (315) 692-0449
Fax: (315) 692-6546
Website:
Map and Directions
Authorized official contact:
Name: Elliot, Edious Kwaipa Doctor of Dental Medicine (DMD)
Phone: (315) 692-0449

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X

Profile Details

NPI number 1649848458
LBN Legal business name Fayetteville-Manlius Oral Surgery, P.C
DBA Doing business as
Authorized official Elliot, Edious Kwaipa Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 16th, 2021
Last updated Jun 16th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649848458 NPPES
New Jersey MEDICAID 163-943-4665

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