Healthcare Provider Details

I. General information

NPI: 1013981281
Provider Name (Legal Business Name): DARIO A FENIMORE D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 SPEEDWELL AVE
MORRIS PLAINS NJ
07950-2133
US

IV. Provider business mailing address

14 TOWER HILL RD
MORRIS PLAINS NJ
07950-2020
US

V. Phone/Fax

Practice location:
  • Phone: 873-538-2238
  • Fax: 973-538-9336
Mailing address:
  • Phone: 973-539-7048
  • Fax: 973-538-9336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI01093600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: