Healthcare Provider Details

I. General information

NPI: 1194849968
Provider Name (Legal Business Name): ALON DENTAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 FRONT ST
ELMER NJ
08318-2177
US

IV. Provider business mailing address

440 FRONT ST P.O. BOX 617
ELMER NJ
08318-2177
US

V. Phone/Fax

Practice location:
  • Phone: 856-358-8303
  • Fax: 856-358-9145
Mailing address:
  • Phone: 856-358-8303
  • Fax: 856-358-9145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22DI00832300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI011554400
License Number StateNJ

VIII. Authorized Official

Name: DR. CHARLES EDWARD NOCCO
Title or Position: PRESIDENT OF ALON DENTAL ASSOCIATES
Credential: D.D.S
Phone: 856-358-8303