Healthcare Provider Details

I. General information

NPI: 1144481961
Provider Name (Legal Business Name): NATHAN JAMES OSTLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

688 BREWERS BRIDGE RD
JACKSON NJ
08527-2017
US

IV. Provider business mailing address

47 WINCHESTER CT.
ABERDEEN NJ
07747
US

V. Phone/Fax

Practice location:
  • Phone: 732-942-6900
  • Fax:
Mailing address:
  • Phone: 213-221-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22DI02540400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: