MEDICARE: MATTHEW S TENAGLIA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	22DI02895400	NJ

General Provider Information

NPI Number	:	1912434549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW S TENAGLIA DMD

Provider Business Mailing Address
First Line	:	101 STONE HARBOR BLVD
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2135
Country	:	US
Telephone Number	:	609-465-3111
Fax Number	:	609-465-5064

Provider Business Practice Location Address
First Line	:	101 STONE HARBOR BLVD
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2135
Country	:	US
Telephone Number	:	609-465-3111
Fax Number	:	609-465-5064

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2017
Last Update Date	:	04/15/2025

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Directions to “ MATTHEW S TENAGLIA DMD” Practice Location

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