is a Oral And Maxillofacial Surgery in Clifton, New Jersey. practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for is 1558312181. The last update date is .
's current location address is 1135 Broad St Ste 100, Clifton, New Jersey. You can contact this provider via phone number 9732560103 and fax number 9732568066. The mailing address for is 1135 Broad St Ste 100, Clifton, New Jersey. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1135 Broad St Ste 100, Clifton, New Jersey |
| Phone Number | 9732560103 |
| Fax Number | 9732568066 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1558312181 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1135 Broad St Ste 100 |
|---|---|
| City | Clifton |
| State | New Jersey (NJ) |
| Post Code | 70133346 |
| Phone Number | 9732560103 |
| Fax Number | 9732568066 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | DI01843000 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5592704 | NJ | -- |
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