Healthcare Provider Details

I. General information

NPI: 1952356792
Provider Name (Legal Business Name): CAPE ATLANTIC ORAL & MAXILLOFACIAL SURGEONS, PA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 STONE HARBOR BLVD
CAPE MAY COURT HOUSE NJ
08210-2135
US

IV. Provider business mailing address

PO BOX 898
CAPE MAY COURT HOUSE NJ
08210-0898
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-4340
  • Fax: 609-465-5064
Mailing address:
  • Phone: 609-465-4340
  • Fax: 609-465-5064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDI09028
License Number StateNJ

VIII. Authorized Official

Name: DR. HARVEY C STRAIR
Title or Position: PRES/OWNER
Credential: DMD
Phone: 609-465-4340