Healthcare Provider Details

I. General information

NPI: 1730156126
Provider Name (Legal Business Name): JOSEPH C PIOTROWSKI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 11/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 MADISON AVE
LAKEWOOD NJ
08701-3214
US

IV. Provider business mailing address

1039 SHEILA DR
TOMS RIVER NJ
08753-3535
US

V. Phone/Fax

Practice location:
  • Phone: 732-363-0800
  • Fax: 732-367-5206
Mailing address:
  • Phone: 732-363-0800
  • Fax: 732-367-5206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number16437
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: