Healthcare Provider Details

I. General information

NPI: 1902997422
Provider Name (Legal Business Name): ORAL RECONSTRUCTIVE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 OLD SHORT HILLS RD SUITE 500
WEST ORANGE NJ
07052-1000
US

IV. Provider business mailing address

101 OLD SHORT HILLS RD SUITE 500
WEST ORANGE NJ
07052-1000
US

V. Phone/Fax

Practice location:
  • Phone: 973-325-3700
  • Fax: 973-325-1177
Mailing address:
  • Phone: 973-325-3700
  • Fax: 973-325-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. BRUCE ROBERT BARNHARD
Title or Position: PRESIDENT
Credential: DDS
Phone: 973-325-3700