Healthcare Provider Details

I. General information

NPI: 1851547178
Provider Name (Legal Business Name): FRANK J. POPLAWSKI,D.M.D.,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 LACEY RD
FORKED RIVER NJ
08731-2618
US

IV. Provider business mailing address

310 LACEY RD P.O.BOX 829
FORKED RIVER NJ
08731-2618
US

V. Phone/Fax

Practice location:
  • Phone: 609-971-0572
  • Fax: 609-971-7375
Mailing address:
  • Phone: 609-971-0572
  • Fax: 609-971-7375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number22DI01132500NJ
License Number StateNJ

VIII. Authorized Official

Name: DR. FRANK J POPLAWSKI
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 609-971-0572