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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SIDNEY LAWRENCE BOURGEOIS JR., D.D.S.

Active

DR. SIDNEY LAWRENCE BOURGEOIS JR., D.D.S. is a Oral & Maxillofacial Surgery healthcare provider located in SYRACUSE, New York. NPI 1629071154 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery · SYRACUSE, NY

Registration Details

NPI Number
1629071154
Provider Type
Individual
Gender
Male
NPI Issued
May 30, 2005 (21.251370840411 yrs)
Last Updated
Jul 28, 2021
Licenses
22617 (TX)
056936 (NY)
22617 (TX)
056936 (NY)

Practice Information

Address
800 IRVING AVENUE (160)
SYRACUSE, NY, 13210
Browse NY providers · Browse ZIP 13210
Phone
3154252468
Fax
3154254415
Primary Specialty
Oral & Maxillofacial Surgery
1223S0112X
Additional Specialty
Oral & Maxillofacial Surgery

Other Oral & Maxillofacial Surgery Providers in SYRACUSE, NY

Name Credential NPI
DR. NANCY CREED DMD 1356304877
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.