Medford Periodontal Associates, Llc in Medford - Periodontics
Medford Periodontal Associates, Llc - NPI 1184808743
Medford Periodontal Associates, Llc is a Periodontics in Medford, New Jersey. Medford Periodontal Associates, Llc practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Medford Periodontal Associates, Llc is 1184808743. The last update date is 2007-12-19.
Medford Periodontal Associates, Llc's current location address is 30 Jackson Rd, Medford, New Jersey. You can contact this provider via phone number 6099533700. The mailing address for Medford Periodontal Associates, Llc is 30 Jackson Rd, Medford, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Medford Periodontal Associates, Llc |
|---|---|
| Address | 30 Jackson Rd, Medford, New Jersey |
| Phone Number | 6099533700 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Canal J Mario |
| Credentials | DMD |
| Telephone Number | 6099533700 |
NPI Number Detail
| NPI Number | 1184808743 |
|---|---|
| Provider Enumeration Date | 2007-12-19 |
| Last Updated Date | 2007-12-19 |
Provider Mailing Address Detail
| Address | 30 Jackson Rd |
|---|---|
| City | Medford |
| State | New Jersey (NJ) |
| Post Code | 80559283 |
| Phone Number | 6099533700 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 22DI01653900 |
|
Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Medford Periodontal Associates, Llc by the Centers for Medicare & Medicaid Services?
The Medford Periodontal Associates, Llc has been assigned the NPI (National Provider Identifier) 1184808743 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Medford Periodontal Associates, Llc's facilities are geographically located?
The facilities of Medford Periodontal Associates, Llc are physically situated at the following location: 30 Jackson Rd, Medford, NJ, 80559283.
What is Medford Periodontal Associates, Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Medford Periodontal Associates, Llc's specialized field of practice is Periodontics, and the corresponding taxonomy code that categorizes this area of specialization is 1223P0300X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1184808743 to Medford Periodontal Associates, Llc?
The Centers for Medicare & Medicaid Services originally issued the 1184808743 to Medford Periodontal Associates, Llc on 2007-12-19.
As of what date were the details pertaining to Medford Periodontal Associates, Llc last refreshed?
The information related to the Medford Periodontal Associates, Llc, including its address, specialty, and other relevant details, was last updated on 2007-12-19.